National Heart Disease and Stroke Prevention Program September 2011 National Center for Chronic Disease Prevention and Health Promotion Division for Heart Disease and Stroke Prevention
National Heart Disease and Stroke Prevention Program
September 2011
National Center for Chronic Disease Prevention and Health Promotion Division for Heart Disease and Stroke Prevention
Welcome
It is with great pleasure that we welcome you to
the National Heart Disease and Stroke Prevention
(NHDSP) program
We have created an orientation guide to help you
understand the Division for Heart Disease and Stroke
Prevention and the NHDSP program Please review all
documents in the guide
Thank you and welcome to the NHDSP program
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
i
Table of Contents
Division for Heart Disease and Stroke Prevention Background and Overview1
National Heart Disease and Stroke Prevention Program Overview 13
State Heart Disease and Stroke Prevention Program Funding
Opportunity Announcement DP07-704 At-A-Glance 17
Management Information System (MIS) At-A-Glance 29
Guidelines for Budget Preparation 32
Program Evaluation Guidance 41
Appendix Websites Publications and Tools 51
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Background and Overview
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
2
The Burden of Heart Disease and Stroke Heart disease and stroke the first and third leading
causes of death for men and women are among the
most widespread and costly health problems facing
our nation today An estimated 935000 heart attacks
and 795000 strokes occur each year One in four
deaths is caused by heart disease and someone dies
of a stroke on average every four minutes Heart
disease and stroke also are among the leading causes
of disability in the United States Nearly 4 million
people report disability from these causes
Death rates alone cannot describe the burden of
heart disease and stroke In 2010 the total costs of
cardiovascular diseases which include heart disease
and stroke were estimated to be $444 billion
Treatment of these diseases accounts for about $1
of every $6 spent on health care in this country As
the US population ages the economic impact of
cardiovascular diseases on our nationrsquos health care
system will become even greater
Overall death rates for heart disease and stroke have
decreased in the United States in recent decades
However rates for incidence and death continue
to be high especially among some populations
including members of certain racial and ethnic
groups people with low socioeconomic status and
those living in the southeastern United States For
example the risk of having a first-ever stroke is
nearly two times higher among African Americans
than among whites In addition about 55000 more
women than men have a stroke each year Recent
studies show that the prevalence of heart disease and
the percentage of associated premature deaths are
higher among American Indians and Alaska Natives
than among any other US racial or ethnic group
The news is not all bad however Scientific evidence
confirms that many lives can be saved through
prevention and early detection The prevention of
cardiovascular diseases also results in significant
savings of our nationrsquos limited health care resources
CDCrsquos Division for Heart Disease and Stroke
Prevention (DHDSP) is committed to having a
positive impact on cardiovascular diseases
The Division for Heart Disease and Stroke Prevention CDC has engaged in heart disease and stroke
prevention work since the late 1980s beginning
with the emergence of the Cardiovascular Health
Studies (CVH) Branch in the National Center for
Chronic Disease Prevention and Health Promotion
(NCCDPHP) In 1998 CDC and the National Institutes
of Health were named co-leaders of the Healthy
People 2010 objectives for heart disease and stroke
In that same year Congress funded CDC to establish
the National Heart Disease and Stroke Prevention
Program which helps build state- and local-level
comprehensive heart disease and stroke programs
In 2001 following the death of Senator Paul
Coverdell from a stroke Congress funded CDC to
establish state stroke registries to capture data that
can be used to measure and improve the quality of
acute stroke care
In 2006 CDC established DHDSP as one of 10
stand-alone divisions within NCCDPHP DHDSP
was created by combining the CVH Branch the
WISEWOMAN program and the office of the
Division of Adult and Community Healthrsquos Associate
Director for CVH Policy and Research WISEWOMAN
provides uninsured women aged 40ndash64 with access
to screening referral and lifestyle interventions to
help reduce their risk for heart disease and other
chronic diseases
DHDSPrsquos mission is to be the nationrsquos public health
leader for achieving cardiovascular health for all and
reducing the burden of disparities in heart disease
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and stroke DHDSP staff collaborate with national
public- and private-sector partners to plan direct
and coordinate programs and research that reduce
risk factors disease deaths and disparities associated
with heart disease and stroke
DHDSP provides national leadership in addressing
key issues such as sodium consumption awareness
of signs and symptoms of heart attack and stroke
and access to screening and interventions for
cardiovascular problems The results of DHDSPrsquos
work are often highlighted in the national media
have gained widespread exposure on the Internet
and have been published in professional and peer-
reviewed journals and publications
The National Forum for Heart Disease and Stroke Prevention CDC the American Heart Association and the
Association of State and Territorial Health Officials
led the development of the landmark publication
A Public Health Action Plan to Prevent Heart
Disease and Stroke (Action Plan) The National
Forum for Heart Disease and Stroke Prevention
was convened to review draft recommendations
for the Action Plan in September 2002 and in
2003 it became a major vehicle for implementing
the plan This national coalition now representing
more than 80 organizations provides strategic
guidance on heart disease and stroke prevention
activities through the Action Plan and promotes
collaboration through an annual meeting held in
Washington DC and face-to-face meetings with
each of its seven implementation work groups The
Action Plan provides states organizations and key
stakeholders with a framework for planning public
health strategies to prevent heart disease and stroke
throughout the nation
DHDSP Goals 1 Prevent risk factors for heart disease and stroke
2 Increase detection and treatment of risk factors
for heart disease and stroke
3 Increase early identification and treatment of heart
disease and stroke
4 Decrease recurrences of cardiovascular events
5 Foster a skilled and engaged public health
workforce to address heart disease and stroke
Organization and Staffing
DHDSP Structure
DHDSP consists of the Office of the Director
(OD) and three branches the Applied Research
and Evaluation Branch (AREB) the Epidemiology
and Surveillance Branch (ESB) and the Program
Development and Services Branch (PDSB)
office of the Director OD is responsible for resource management research
coordination communications partnership building
external affairs coordination of policy and legislative
activities and global collaborations OD staff
participate in and manage activities related to
Division partnerships such as CDCrsquos Cardiovascular
Health Collaboration the National Forum and the
Healthy People 2010 Partnership
Program Development and services Branch PDSB promotes evidence-based strategies and
programs to reduce health disparities and prevent
heart disease and stroke throughout the nation It
funds and manages cooperative agreements with
states tribal organizations and partners and provides
technical assistance to staff in the National Heart
Disease and Stroke Prevention Program PDSB
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DHDSP Organizational Structure
Office of the Director
Deputy Director Administrative Office
Associate Director for Science
Strategic Planning Partnerships and External Relations
Global Health Coordinator
Epidemiology and Surveillance Branch
Program Development and Services Branch
WISEWOMAN Team
Senior Advisor to Division Director
Applied Research and Evaluation Branch
Planning Partnerships and Policy Team
Health Communication and Program Information Team
Statistical Unit
Epidemiology and Surveillance Team
Small Area Analysis Team
Health Services Research and Registries Team
Program Services Team Applied Research and Translation Team
Evaluation and Program Effectiveness Team
4
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provides grantees with comprehensive technical
assistance training and programmatic tools and
guidance for the development implementation
and evaluation of programs Together with related
programs across NCCDPHP PDSB provides
leadership to ensure collaboration that can affect
heart disease and stroke prevention outcomes
epidemiology and surveillance Branch ESB studies patterns and trends in the following areas
as they relate to cardiovascular diseases risk factors
costs health behaviors and outcomes barriers to
patient access to care public awareness geographic
variation and disparity of cardiovascular disease
rates among races and ethnic groups These scientific
findings allow DHDSP and its partners to respond
to emerging health risks and promote public health
practice ESB funds and manages the Paul Coverdell
National Acute Stroke Registry Staff provide technical
assistance and expertise through scientific articles
research findings geographic information system
mapping and promotion of new surveillance
methods and technologies
applied research and evaluation Branch AREB works with states partners and colleagues to
conduct and translate applied research and evaluation
of heart disease and stroke prevention efforts It
evaluates programs policies and interventions to
ensure they are working as planned and producing
the intended results It promotes evidence-based
practice by translating scientific findings into practical
resources and tools for public health practitioners
health care providers and others working to prevent
heart disease and stroke In addition AREB supports
state program activities through technical assistance
guidance resource development and capacity
building for applied research and evaluation
Funded Programs DHDSP funds and supports three national heart
disease and stroke prevention programs The fiscal
year 2010 appropriation was $56 million for heart
disease and stroke prevention programs Funds
are awarded through a competitive process for
the National Heart Disease and Stroke Prevention
Program Paul Coverdell National Acute Stroke
Registry and Sodium Reduction in Communities
Program
National Heart Disease and Stroke Prevention Program
The National Heart Disease and Stroke Prevention
Program provides funding and support to state
health departments to manage heart disease and
stroke prevention programs at the state and local
levels DHDSP shares the latest science and practices
with states to help reduce disease deaths and
health disparities related to heart disease and stroke
especially among those at high risk The program
has grown from funding 8 states in 1998 to funding
41 states and the District of Columbia in the current
funding cycle Twenty-eight states are funded for
capacity building and 14 for basic implementation
CDC-funded state programs promote changes to
policies and systems in health care worksite and
community settings and the elimination of health
disparities by emphasizing the ABCS of heart
disease and stroke prevention Some programs also
work to improve emergency response and quality
of acute care
WISEWOMAN
The Well-Integrated Screening and Evaluation for
WOMen Across the Nation (WISEWOMAN) Program
helps women with little or no health insurance
access services that can help reduce their risk for
heart disease stroke and other chronic diseases
The priority age group is women aged 40ndash64 years
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2010 Funded Programs
2011 Funded Programs
NHDSP Funded States
WISEWOMAN Programs
WA
MT
ID WY
NV
AK
HI
AZ NM
TX
KSCO
OK
SD
ND
AR
IN OH
KY
TN
LA ALMS
FL
GA
NY
ME
OR
UT
CA
NE IA
MO
WI
IL
MN
MI
VAWV
SC
NC
PA NH
DE
VT
MD
NJ
RI
DC
MA
CT
Coverdell Stroke Registry States
Sodium Reduction Communities
Unfunded States
Note WISEWOMAN funds two tribal organizations in Alaska but not the state health department
Congress authorized the program in 1993 as an
expansion of services offered through the National
Breast and Cervical Cancer Early Detection Program
DHDSP funds WISEWOMAN programs in 19 states
and 2 tribal organizations Working in local clinics
and health care settings WISEWOMAN provides
heart disease and stroke risk factor screenings and
offers lifestyle interventions to help women increase
their physical activity improve their diet and engage
in tobacco cessation efforts
Paul Coverdell National Acute Stroke Registry
DHDSP funds states to establish surveillance systems
that measure track and provide data to help improve
the delivery and quality of stroke care among acute
stroke patients In 2001 Congress funded CDC to
establish the Paul Coverdell National Acute Stroke
Registry after US Senator Paul Coverdell of Georgia
suffered a fatal stroke while serving in Congress
The goal of the Coverdell Registry is to ensure that
all stroke patients receive the highest quality acute
stroke care available to reduce untimely deaths
prevent disability and avoid recurrent strokes With
Coverdell Registry data states and their health care
partners identify and analyze gaps in stroke care
systems and plan targeted strategies to address
them In June 2004 CDC funded four state health
departments (Georgia Illinois Massachusetts
and North Carolina) to establish Paul Coverdell
National Acute Stroke Registries In the most recent
Paul Coverdell National Acute Stroke Registry
funding cycle (2007ndash2011) CDC funded state health
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departments in Georgia Massachusetts Michigan
Minnesota Ohio and North Carolina In 2007
CDC The Joint Commissionrsquos Primary Stroke Center
Certification program and the American Heart
AssociationAmerican Stroke Associationrsquos Get With
The Guidelinesreg-Stroke program jointly released a set
of standardized stroke performance measures to be
used by all three programs This effort has reduced
duplication of effort increased collaboration and
encouraged hospitals to participate in the programs
Office of the Director
Mississippi Delta Health Collaborative (Delta Health Initiative)
The Mississippi Delta Health Collaborative (MDHC)
is designed to prevent heart disease stroke and
related chronic diseases Through a new five-year
cooperative agreement this initiative will intensify
collaboration among the Mississippi Department of
Health existing chronic disease programs (eg heart
disease and stroke prevention diabetes tobacco
nutrition physical activity) local health departments
other community health care providers (eg
federally qualified health centers) local communities
and CDC This result will be achieved through
implementation of interventions across Mississippirsquos
18-county Delta Region The program will target
the ldquoABCSrdquo of heart disease and stroke prevention
among priority populations in high burden
underserved rural areas
bull Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
bull Hemoglobin A1c (HbA1c) Monitor and control
blood glucose
bull Blood pressure Prevent and control high blood
pressure
bull Cholesterol Prevent and control high LDL-
cholesterol
bull Smoking Prevent initiation and increase cessation
of smoking and increase the percentage of the
population protected by smoke-free air laws or
regulations
The Mississippi Department of Health will provide
leadership and funding support in the Delta
Region to implement prioritized population-based
interventions policy systems and environmental
change selected as appropriate from a set of
prescribed evidence-based strategies in both the
clinical and community settings
WISEWOMAN
The WISEWOMAN Program began a new five-
year funding cycle June 30 2008 The competitive
application process resulted in 21 programs being
funded This is an increase of six programs from the
previous funding cycle Seventeen WISEWOMAN
programs also receive funding to implement the
National Heart Disease and Stroke Prevention
Program
One major focus of the funding opportunity
announcement (FOA) is development of partnerships
At a minimum funded programs are expected to
partner with their statetribal Breast and Cervical
Cancer Early Detection Program Tobacco Control
Program Heart Disease and Stroke Prevention
ProgramCoalition and other programs that
can affect policies and environments in which
WISEWOMAN participants live work and play
Because the majority of WISEWOMAN funding must
be spent on providing direct services to women
partnerships are extremely important to ensure
participant access to affordable and quality resources
to support heart health
WISEWOMAN evaluation emphasizes program
improvement and is based on the CDC Framework
for Program Evaluation in Public Health CDC has
developed key evaluation questions related to the
programrsquos stated goals and logic model components
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The questions are used in the evaluation of the
WISEWOMAN Program Funded programs are
required to conduct evaluations to assess progress
toward meeting stated work plan objectives and to
share results with others including their providers
partners other stakeholders and CDC Funded
programs contribute to the WISEWOMAN Program
evaluation by providing Minimum Data Elements
data submitting information to CDC that supports
program evaluation activities and participating in
activities such as site visits and case studies
Sodium Reduction in Communities
High sodium consumption is a major contributor
to high blood pressure a leading cause of stroke
coronary heart disease heart attack and heart and
kidney failure in the United States The 2010 Dietary
Guidelines for Americans recommend limiting
sodium to less than 2300 milligrams (mg) per day
Individuals who are 51 and older and those of any
age who are African American or have hypertension
diabetes or chronic kidney disease should limit
intake to 1500 mg of sodium per day These groups
account for about half the US population and the
majority of adults
Studies show that on average US adults consume
more than 3400 mg of sodium per day An estimated
77 percent of sodium comes from processed and
restaurant foods Reducing dietary intake of sodium
to 2300 mg per day could prevent as many as 11
million cases of hypertension in the United States
Further reductions in sodium intake to 1500 mg per
day could prevent more than 16 million cases
Through the three-year Sodium Reduction in
Communities cooperative agreement which began in
September 2010 DHDSP is providing support to six
communities to support policy changes designed to
create healthier food environments The communities
receiving support include California (Shasta County)
Kansas (Shawnee County) Los Angeles County
New York City and New York State (Broome and
Schenectady counties)
Program Development and Services Branch
Funded State Programs
National Heart Disease and Stroke Prevention Program The enhanced reach of the National
Heart Disease and Stroke Prevention Program was
a key accomplishment in 2008 Eight new states
(Connecticut Hawaii Idaho Iowa Maryland New
Jersey North Dakota and West Virginia) were funded
as part of the program bringing the total number of
funded programs to 42
Leadership to Center Integration PDSB has
provided leadership to NCCDPHPrsquos initiative to
increase synergy reach and desired health outcomes
in selected NCCDPHP-funded categorical programs
(National Heart Disease and Stroke Prevention
Diabetes Prevention and Control Tobacco Control
Comprehensive Cancer Control Nutrition Physical
Activity and Obesity and the Behavioral Risk Factor
Surveillance System)
National Training DHDSP conducted the 2008
National Heart Disease and Stroke Prevention
Training Institute on September 9ndash11 in Atlanta The
training focused on longer skill-building interactive
workshops that addressed the competencies
program priorities and performance measures of
the FOAs for DHDSPrsquos funded programs It included
the National Heart Disease and Stroke Prevention
Program and WISEWOMAN and was expanded to
include representation from each statersquos heart disease
program as well as American Heart Association
field staff working in the states Informal feedback
indicates that the training has already led to greater
collaboration at the state level
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Management Information System (MIS) In 2008
DHDSP completed revisions for the heart disease
and stroke prevention Web-based MIS The report
generated by the system was changed to a table that
displays an objective time frame status and progress
in an easy-to-read format These changes made the
system more user friendly for states and CDC The
MIS can now be used to
bull Describe state program activities and expected
use of CDC funds
bull Track progress on state program activities and
identify promising practices
bull Assist CDC in identifying the need for training
and technical assistance
bull Standardize the state reporting process to
facilitate evaluation
bull Enable CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Funded Partnerships
Directors of Health Promotion and Education
(DHPE) In 2008 DHDSP continued to support
the DHPECDC Internship Program for Students
of Minority Serving Institutions
National Stroke Association DHDSP assisted with
funding for the Sixth Annual National Public Health
Stroke Summit conducted by the National Stroke
Association in Denver Colorado in December 2007
The Summit brought together 105 state public health
and health care professionals to promote information
sharing knowledge and skill building networking
and partnership development
National Collaborations
Cardiovascular Health (CVH) Council of the National Association of Chronic Disease Directors (NACDD) In 2008 the CVH Council
updated its section of the NACDD website to include
additional materials useful to states and it started
a Web discussion forum that allows states to share
ideas and products The Council obtained private
funds and sponsored the 2-day Northeast Regional
Workshop on Cholesterol Control in which 11
states participated in May 2008 It also funded two
of the participating states (Maine and Maryland)
to do follow-up work on cholesterol control with
their primary care associations and local federally
qualified health centers In March 2008 the
Council led the development of a themed issue of
the e-journal Preventing Chronic Disease In most
cases state program staff coauthored articles with
DHDSP staff The CVH Council worked with DHDSP
to assess the training needs of state programs in
the National Heart Disease and Stroke Prevention
Program and DHDSP used this information to plan
its September 2008 3-day training workshop for state
program and WISEWOMAN staff
Epidemiology and Surveillance Branch
Cardiac Arrest Registry to Enhance Survival
The Cardiac Arrest Registry to Enhance Survival
(CARES) began in 2005 in Atlanta and has since
expanded to 40 communities in 23 states CARES is
a simple but robust registry of cardiac arrest events
that allows participating sites to enter data related
to out-of-hospital cardiac arrest (OHCA) generate
summary reports and compare local data with
similar EMS systems elsewhere Three sources of
data are linked to describe each OHCA event 1)
9-1-1 call center data (to provide incident address
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and dispatch and arrival times) 2) EMS data (to
describe initially recorded cardiac rhythm and
treatment methods) and 3) hospital data (emergency
department and hospital outcome hypothermia
treatment and neurologic status at discharge)
Multiple reporting features can be generated and
monitored continuously through secure online access
by CARES participants which allows for longitudinal
internal benchmarking Local EMS administrators
and medical directors are able to identify when and
where cardiac arrests occur which elements of their
EMS system are functioning properly in dealing
with these cases and what changes can be made to
improve outcomes In 2011 CARES began expanding
to statewide participation in six states which will
allow additional communities of different sizes and
population densities to be included in the registry In
addition state-level participation will promote better
communication and collaboration between state and
local EMS providers A recent MMWR Surveillance
Summary was published summarizing CARES data
collected during October 1 2005ndashDecember 31
2010 (wwwcdcgovmmwrpdfssss6008pdf) More
information about CARES can be found on the
CARES website at httpsmycaresnet
Paul Coverdell National Acute Stroke Registry
New Registries The Paul Coverdell National
Acute Stroke Registry program successfully
implemented stroke registries in three newly
funded states in 2007 (Michigan Minnesota and
Ohio) These states made much greater progress
in their first year toward developing program
infrastructure collecting data and engaging in
quality improvement activities than had the four
states that completed their first year of Coverdell
Registry funding in 2004 Much of this progress can
be attributed to CDCrsquos increased capacity to provide
proactive technical assistance to states through
conference calls work groups and resource
materials such as the program resource manual
Supplemental Projects The Coverdell Registry
team developed and funded a supplemental
cooperative agreement to pilot the expansion of
the Coverdell Registry model to other domains
within stroke systems of care North Carolina was
funded to demonstrate the feasibility of linking
pre-hospital EMS data for stroke with the state
Coverdell Registry (the North Carolina Stroke
Care Collaborative) In 2010 in partnership with
the Association of State and Territorial Health
Officials CDC funded two Coverdell states to
develop comprehensive statewide stroke care
systems plans CDC is currently funding the Ohio
Coverdell Registry to study 30-day outcomes
of stroke patients based on the quality of care
provided In partnership with the Agency for
Healthcare Research and Quality CDC has funded
an evidence-based review of transitions in care
from hospital to home or rehabilitation for stroke
patients
National Evaluation Plan Through a yearlong
collaboration with RTI International the Coverdell
Registry developed a national evaluation plan The
plan provides a systematic method of assessing
the annual and long-term performance of the
program including strategic goals and objectives
performance goals performance measures and
targets for program outcomes
Consensus Stroke Performance Measures
Endorsement of the Consensus Stroke
Performance Measures The Coverdell Registry
partnered with the American Heart Association
and The Joint Commission to develop performance
measures for acute stroke care commonly
referred to as the Consensus Stroke Performance
Measures These measures were released to
hospitals throughout the United States in fall
2007 In January 2008 more than 1200 hospitals
began using these measures to improve the quality
of care for acute stroke patients The measures
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were submitted to the National Quality Forum in
March 2008 and 8 of the 10 were adopted This
endorsement of the Consensus Stroke Performance
Measures has paved the way for adoption of
these measures by the Centers for Medicare
and Medicaid Services for quality reporting and
meaningful use
Quarterly Data Reports With the implementation
of the Consensus Stroke Performance Measures in
January 2008 CDC began providing states with
quarterly data reports on the measures These
reports provide each state with a summary of its
data on ischemic stroke hemorrhagic stroke and
transient ischemic attacks as well as aggregate data
for all states in the Coverdell Registry program
Applied Research and Evaluation Branch
Building an Economic Evaluation Research Agenda
Based on program needs and research gaps in heart
disease and stroke prevention the Applied Research
and Evaluation Branch developed an agenda to
guide economic research on 1) economic burden
of cardiovascular diseases and cost-effectiveness of
their control 2) economic value of DHDSP-funded
and other state prevention programs 3) CDCrsquos
Internet-based clearinghouse for information on
the economics of cardiovascular diseases and 4)
developing partnerships in economic research to
increase the impact of such research
Stroke Awareness Signs and Symptoms Awareness Campaigns
To provide guidance for state programs a review of
current research on stroke awareness campaigns was
undertaken to identify evidence to support the most
appropriate ways to increase knowledge of signs and
symptoms for stroke the importance of calling 9-1-1
and relationships between the educational campaigns
and outcomes related to awareness of stroke signs
and symptoms
The literature review and synthesis of current
research on stroke awareness campaigns resulted
in the following dissemination activities
bull Development of a fact sheet for state programs on
literature review findings and considerations for
statesrsquo current activities related to stroke awareness
messages including direct education and tools
available to facilitate campaign development
bull Poster presentation at the 2008 National
Conference on Health Communication Marketing
and Media on evaluation guidance for stroke
awareness campaigns The presentation outlined
specific information for states and communities on
how to strengthen the effectiveness and outcome
evaluation of their stroke awareness campaigns
bull Presentation at the 2008 National Heart Disease
and Stroke Prevention Training Institute about
evidence and research on communication and
media campaigns impact considerations of cost
opportunities for partnering and evaluating
results
Comprehensive and Core Indicators
DHDSP released a set of core indicators for
hypertension as part of a comprehensive evidence-
based set of indicators to guide state heart disease
and stroke prevention programs in evaluating their
efforts State health departments received related
key guidance documents training at the National
Heart Disease and Stroke Prevention Training
Institute and a series of follow-up trainings
Indicators are presented in a Consumer Reports
format and rated on multiple dimensions such as
strength of scientific evidence feasibility of data
collection and face validity
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Successful Business Strategies to Prevent Heart Disease and Stroke Toolkitmdash Evaluation Results
CDC worked with the American Institutes for
Research (AIR) to conduct an evaluation of the
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit State health departments
(SHDs) were trained to use the toolkit to promote
state employer-based initiatives on workplace efforts
for heart disease and stroke prevention
From 2005 to 2007 all the SHDs received copies of
the toolkit and were invited to attend training sessions
(one seminar five webinars and three consultations)
To evaluate the usefulness of the toolkit materials
and obtain recommendations two focus groups with
business leaders and Web-based surveys of the SHDs
were conducted In 2006 all 50 states and the District
of Columbia completed the baseline and in 2008 40
states completed the follow-up
Of the 40 SHDs that completed both waves of the
survey the proportion that reported engaging in
employer-based initiatives significantly increased
from 65 percent to 725 percent during the period
examined despite a reported reduction in staff and
limited appropriations About 90 percent of the
SHDs that responded to the 2008 survey are now
working with employers to promote comprehensive
heart disease and stroke prevention programs
disseminate best practices establish employer-
oriented partnerships participate in seminars for
employers and provide business leaders with
resources Partnerships with employer groups or
business coalitions have focused on worksite policy
changes health promotion and education and
worksite surveillance and assessments In parallel
to these experiences the SHDs have increased their
overall level of confidence in their knowledge and
skills Most of the SHDs (61 percent) agreed that
the CDC trainings and consultations helped them
improve their heart disease and stroke prevention
programs and use the toolkit more effectively
Participation in the trainings was positively associated
with engagement in worksite health promotion and
education The SHDs that received federal funding
had significantly higher participation in macro-
marketing activities reaching employers through
business coalitions associations task forces and
champions and were more likely to establish
partnerships with employer groups and government
agencies
The Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit is available at wwwcdc
govdhdsplibrarytoolkitindexhtm
The Branch also provides economics support to
the Division and partners by documenting costs of
cardiovascular diseases and their risk factors and
identifying cost-effective interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
13
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
National Heart Disease and Stroke Prevention Program Overview
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
14
u Blood pressure Prevent and control high blood Program Overview pressure reduce sodium intake
bull In 1998 the US Congress provided funding
for CDC to initiate a national state-based Heart
Disease and Stroke Prevention (HDSP) program in
eight states
bull CDC funds programs in 41 states and the
District of Columbia Twenty-eight are capacity
building (planning) programs and 14 are basic
implementation (intervention) programs
bull Capacity Building Programs Alabama
Alaska Arizona California Colorado Connecticut
District of Columbia Hawaii Idaho Illinois Iowa
Kansas Kentucky Louisiana Maryland Michigan
Minnesota Mississippi Nebraska New Jersey
North Dakota Ohio Oklahoma Oregon Rhode
Island Tennessee Texas and Wisconsin
bull Basic Implementation Programs Arkansas
Florida Georgia Maine Massachusetts Missouri
Montana New York North Carolina South
Carolina Utah Virginia Washington and West
Virginia
National Heart Disease and Stroke Prevention Program Goals bull Enhance state capacity to plan implement track
and sustain population-based interventions to
address heart disease stroke and related risk
factors Focus program efforts on population-
based policy and systems change strategies to
impact the ldquoABCSrdquo of heart disease and stroke
prevention
u Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
u Cholesterol Prevent and control high
cholesterol
u Smoking Increase the number of smokers
counseled to quit and referred to quitlines by
health care workers increase availability of no
or low-cost cessation products and collaborate
with efforts to increase the percentage of the
population protected by smoke-free air laws
and regulations
To a lesser extent state HDSP programs work to
improve emergency response and quality of acute
care systems
State HDSP programs work to eliminate health
disparities in priority populations (ie groups with
increased burden or need based on race ethnicity
gender geography or socioeconomic status) as an
overarching principle
bull Collaborate with chronic disease programs (eg
those focusing on tobacco diabetes physical
inactivity poor nutrition and obesityoverweight)
and partners to develop and integrate population-
based strategies to prevent heart disease and
stroke
bull Promote cardiovascular health in health care
worksite and community settings through policy
and systems changes
bull Identify and evaluate promising practices to
address heart disease and stroke
bull Conduct surveillance of heart disease stroke
and related risk factors
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
15
u
u
Key Responsibilities of State Capacity Building Programs bull Facilitate collaboration with public- and private-
sector partners such as not-for-profit health
agencies health systems organizations emergency
response agencies federally funded health centers
businesses priority population organizations and
voluntary health organizations
bull Document the state burden of heart disease
stroke and related risk factors
bull Develop plans for population-based strategies
for preventing heart disease and stroke among
general and Priority Populations
bull Develop a comprehensive state HDSP plan
bull Develop an HDSP program logic model and
evaluation plan
bull Assess assets and gaps in state policy and systems
related to HDSP in health care worksite and
community settings
Key Responsibilities of State Basic Implementation Programs bull Enhance all capacity-building program activities
bull Implement and evaluate policy systems change
and educational interventions that address the
six HDSP program priority areas in health care
worksite and community settings
bull Provide training and technical assistance to
public health and health care professionals and
partners to support policy and system changes
that will encourage heart disease and stroke
prevention
How CDC Assists State Heart Disease and Stroke Prevention Programs bull Provides training technical assistance and
funding
bull Funds applied research on heart disease and
stroke interventions and elimination of disparities
that is relevant to state programs
bull Identifies and disseminates science-based
promising practices
bull Partners with national organizations to help states
address prevention of heart disease and stroke
bull Facilitates collaborations with other state chronic
disease programs or activities that address risk
factors populations or settings related to heart
disease and stroke prevention and program
priority areas
bull Develops and disseminates publications and tools
such as
u CDCynergy a CD-ROM-based tool for
planning health communication interventions
State Heart Disease and Stroke Prevention
Program Evaluation Framework (wwwcdc
govdhdsplibraryevaluation_framework
indexhtm) a document providing guidance
on systematic ways to measure the success of
public health programs and on logic model
development
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping an
Evaluation Plan (wwwcdcgovDHDSPstate_
programevaluation_guidesevaluation_plan
htm) a document providing guidance on the
development of evaluation activities to help
programs identify required staff time and
resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
16
u
u
u
u
u
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping and
Using a Logic Model (wwwcdcgovDHDSP
state_programevaluation_guideslogic_model
htm) a document providing guidance on
the development and use of logic models as
planning and evaluation tools
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashWriting SMART
Objectives (wwwcdcgovDHDSPstate_
programevaluation_guidessmart_objectives
htm) a document providing guidance to
states on the development of realistic and
measurable objectives
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit (wwwcdcgov
dhdsplibrarytoolkitindexhtm) a document
that provides information materials and
tools that state programs can reference and
distribute to businesses primarily through
employer and professional organizations
Heart Disease and Stroke Interactive Maps
(wwwcdcgovdhdsplibrarymapsstatemaps
htm) which present heart disease and stroke
mortality rates by county for the state racial
ethnic group and gender of the userrsquos choice
A Communication Guide for Policy and
Environmental Change (wwwcdcgovdhdsp
libraryheart_stroke_guideindexhtm) which
includes information references and examples
of communication from state programs and
Stroke Addendum to the Communication
Guide (wwwcdcgovdhdsplibraryheart_
stroke_guideindexhtm)
For additional information please visit the CDC
website at wwwcdcgovdhdsp or contact the
Division for Heart Disease and Stroke Prevention
Program Development and Services Branch at
(770) 488-2424
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
17
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
State Heart Disease and Stroke Prevention Program Funding Opportunity Announcement DP07-704 At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
18
Introduction The Funding Opportunity Announcement
(FOA) DP07-704 At-A-Glance provides important
information to assist programs funded under this
announcement to deliver their program as intended
The At-A-Glance highlights aspects of FOA DP07-704
important for all funded programs including
the following
bull Overview of the National Heart Disease and
Stroke Prevention Program
bull Heart Disease and Stroke Prevention State
Program roles
bull Performance measures for Capacity Building Basic
Implementation Optional Funding for Capacity
Building programs and Stroke Networks
bull Funded program reporting requirements
bull Budgetfunding guidance
bull National and administrative policy requirements
If a program needs a copy of the full document
it should contact its project officer (see Program
Contacts section of the full National Heart Disease
and Stroke Prevention Program Staff Orientation
Manual) to fulfill that request
Section 1 Background In 1998 the US Congress provided funding for
CDC to initiate a national state-based cardiovascular
health program The Senate Appropriations
Committee in 2005 encouraged CDC to create the
Division for Heart Disease and Stroke Prevention and
increased resources enabling CDC to reach 32 of the
50 states and the District of Columbia with funding
for heart disease and stroke prevention As of 2008
the Heart Disease and Stroke Prevention (HDSP)
program funds 41 states and the District of Columbia
As the Division for Heart Disease and Stroke
Prevention developed so did the focus of the State
HDSP Program Focusing on the six program priority
areas (noted below) should impact morbidity and
mortality of these diseases State programs should
increase heart disease and stroke prevention policies
and systems change with the potential to impact
the general population and Priority Populations
(see Prevention Works CDC Strategies for a Heart-
healthy and Stroke-free America wwwCDCgov
dhdsplibrary) For more information on the CDC
State HDSP Program visit wwwcdcgovdhdspState_
programindexhtm
A Public Health Action Plan to Prevent Heart Disease
and Stroke (see wwwCDCgovdhdsplibrary)
documents the multiple intervention opportunities
for preventing heart disease and stroke It is
important to work with partners collaboratively in
leveraging resources to address the multiple risk
factors that are associated with these diseases
Announcement DP07-704 supports program
components considered essential to enhancing
the leadership of state health departments in
heart disease and stroke prevention It provides
for the funding of capacity building and basic
implementation programs as well as projects such as
the Optional Funding for Capacity Building Programs
and Stroke Networks
A capacity building program develops the foundation
for a comprehensive cardiovascular disease prevention
program through such activities as partnership
development definition of the burden and
development of a state plan A basic implementation
program enhances capacity building activities and
implements disseminates and evaluates intervention
activities that address the state plan objectives and the
CDC program priority areas 1ndash6
1 Increase control of high blood pressure primarily
in adults and older adults
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19
2 Increase control of high blood cholesterol
primarily in adults and older adults
3 Increase knowledge of signs and symptoms for
heart attack and stroke and the importance of
calling 9-1-1
4 Improve emergency response
5 Improve quality of heart disease and stroke care
6 Eliminate disparities in terms of race ethnicity
gender geography or socioeconomic status
Optional Funding for Capacity Building Programs
provides support to programs to implement an
evidence-based or promising practice demonstration
project that addresses the CDC program priority
areas 1ndash6
Stroke Networks support a state health department to
increase stroke prevention activities across a group of
three to six contiguous member states with emphasis
on increasing awareness and implementing priority
policy or systems changes across the states
The State HDSP Program is anchored on the
framework of the Socio-ecological Model which
conceptualized the influences of individual
behaviors family and social relationships community
and environmental effects and societal influences
such as policies on health status In order to
promote significant impact for improving the health
of the population interventions should focus on
implementing policy and systems change strategies
that support heart disease and stroke prevention
Policy change can be addressed through a) public
policy (eg establishing certification for hospital-
based stroke centers) or b) organizational policy
(eg businesses providing health benefits plans
that cover preventive services that include blood
pressure control)
System changes are encouraged in three settings
worksites health care and communities An
example of a systems change is when a health
care setting implements electronic records and
patient care management systems that improve the
quality of health care Interventions within systems
are encouraged at the highest level possiblemdashfor
example activities with business coalitions rather
than individual worksites and with managed care
organizations (MCOs) and state medical associations
rather than individual health care sites or physicians
By working at higher levels to affect systems change
states can impact larger segments of the population
Education and awareness efforts to enhance
public understanding and promote actions related
to cardiovascular diseases and the risk factors of
high blood pressure and high cholesterol signs
and symptoms of heart attack and stroke and the
need to call 9-1-1 are also components of capacity
enhancement
An overarching goal of the State HDSP Program
is to address disparities in heart disease and
stroke and the related risk factors using policy and
systems change strategies Based on disparities
(eg raceethnicity gender geographic geography
socioeconomic status) in mortality access to care
or burden of risk factors the State HDSP Program
should identify Priority Populations and implement
interventions to reach those Priority Populations
No one organization will be able to address the
prevention of heart disease and stroke It will require
many organizations working in collaboration if
progress is to be made in accomplishing the Healthy
People 2010 Objectives Collaboration is defined
by the Wilder Foundation as ldquoa mutually beneficial
and well-defined relationship entered into by two
or more organizations to achieve common goals
The relationship includes a commitment to mutual
relationships and goals a jointly developed structure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
20
and shared responsibility mutual authority and
accountability for success and sharing of resources
and rewardsrdquo Developing and maintaining
strategic partnerships are key to the leveraging of
skills and resources to prevent heart disease and
stroke in a comprehensive way The State HDSP
Program has two major roles related to partners
The first is to convene or facilitate collaboration
to develop and implement a comprehensive state
plan and intervention implementation strategies
that addresses heart disease stroke and related
risk factors The second is to develop strategies to
leverage resources and coordinate interventions
with partners that address the six program
priority areas
A logic model has been developed to describe
the State HDSP Program as intended by the CDC
funding to state health departments (see following
page) The model depicts relationships and actions
(eg links between environment and policy
change and individual-level behavioral change)
that are expected to culminate in reduction in
heart disease and stroke
The CDC and state activities are outlined in terms
of capacity building surveillancemonitoring
and interventions Both CDC and state activities
influence changes that lead to short-term
outcomes such as development of a work plan
and strategies for system-level changes effective
implementation of interventions and action by
target audiences and change agents (those who are
in the position to influence policies and systems
such as hospital administrators and MCO decision
makers) These activities and outcomes result in
changes in policy and environmental supports
which in turn influence behavior changes and
improve health status Ultimately these changes
decrease premature death and disability and
eliminate cardiovascular disparities between
general and Priority Populations
The State HDSP logic model also is a tool to guide
program evaluation By identifying the steps
necessary to reach intended outcomes the logic
model provides guidance in evaluating the short and
intermediate outcomes of the program
State evaluation efforts should relate to the National
HDSP Program logic model or to a logic model that
the state develops that complements the national
model and the required program recipient activities
The logic model can also be seen in the CDC
Evaluation Framework for Heart Disease and Stroke
Prevention State Programs at wwwcdcgovdhdsp
Section 2 National Heart Disease and Stroke Prevention State Program Roles In A Public Health Action Plan to Prevent Heart
Disease and Stroke there are four major goals which
are based on Healthy People 2010
Goal 1 Prevention of risk factors
Goal 2 Detection and treatment of risk factors
Goal 3 Early identification and treatment of heart
attacks and strokes
Goal 4 Prevention of recurrent cardiovascular events
CDC-funded State HDSP Programs have a direct
impact on Goals 2 3 and 4 by addressing HDSP
program priority areas 1ndash6 (see Background section)
HDSP programs have a supportive role with other
state health department programs and partners in
addressing Goal 1 Efforts to address Goal 1 related
to tobacco use diabetes obesity poor nutrition
physical inactivity and schools as a worksite should
be done through a supportive or collaborative role
with the state WISEWOMAN diabetes tobacco
nutrition physical activity or coordinated school
health programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
bull State HDSP Programs are encouraged to
coordinate with other programs in ways that
1 Address Goal 1 (eg State HDSP and Nutrition
Programs identify primary prevention messages
related to cholesterol and salt to be included in Nushy
trition Programs where appropriate State HDSP and
Tobacco Programs collaborate to promote use of
state tobacco quit lines State HDSP Program refers
managed care organizations to materials developed
by the Parks and Recreation Department and
Physical Activity Program on safe places to exercise
National HDSP Program Logic Model
State HDSP and WISEWOMAN Programs collaborate
to create systems for educating health care providers
on guidelines focused on risk factor prevention)
2 Enhance inclusion of key messages in the work
of related programs (eg State HDSP Program
works to implement JNC7 guidelines which
include referral to nutrition counseling the
WISEWOMAN Program incorporates education on
signs and symptoms of heart disease and stroke
into ongoing activities the State HDSP Program
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and system change supports
Level bull State bull Local
Settings bull Community bull Health care bull Worksite
Context bull Priority
Populations bull General
populations
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective intervention
implemented focused on
settings and Priority Populations
Change agents
take action
Activate intended audiences
Capa
city B
uildin
gSu
rveil
lance
Inter
vent
ions
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
21
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
Welcome
It is with great pleasure that we welcome you to
the National Heart Disease and Stroke Prevention
(NHDSP) program
We have created an orientation guide to help you
understand the Division for Heart Disease and Stroke
Prevention and the NHDSP program Please review all
documents in the guide
Thank you and welcome to the NHDSP program
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
i
Table of Contents
Division for Heart Disease and Stroke Prevention Background and Overview1
National Heart Disease and Stroke Prevention Program Overview 13
State Heart Disease and Stroke Prevention Program Funding
Opportunity Announcement DP07-704 At-A-Glance 17
Management Information System (MIS) At-A-Glance 29
Guidelines for Budget Preparation 32
Program Evaluation Guidance 41
Appendix Websites Publications and Tools 51
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Background and Overview
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
2
The Burden of Heart Disease and Stroke Heart disease and stroke the first and third leading
causes of death for men and women are among the
most widespread and costly health problems facing
our nation today An estimated 935000 heart attacks
and 795000 strokes occur each year One in four
deaths is caused by heart disease and someone dies
of a stroke on average every four minutes Heart
disease and stroke also are among the leading causes
of disability in the United States Nearly 4 million
people report disability from these causes
Death rates alone cannot describe the burden of
heart disease and stroke In 2010 the total costs of
cardiovascular diseases which include heart disease
and stroke were estimated to be $444 billion
Treatment of these diseases accounts for about $1
of every $6 spent on health care in this country As
the US population ages the economic impact of
cardiovascular diseases on our nationrsquos health care
system will become even greater
Overall death rates for heart disease and stroke have
decreased in the United States in recent decades
However rates for incidence and death continue
to be high especially among some populations
including members of certain racial and ethnic
groups people with low socioeconomic status and
those living in the southeastern United States For
example the risk of having a first-ever stroke is
nearly two times higher among African Americans
than among whites In addition about 55000 more
women than men have a stroke each year Recent
studies show that the prevalence of heart disease and
the percentage of associated premature deaths are
higher among American Indians and Alaska Natives
than among any other US racial or ethnic group
The news is not all bad however Scientific evidence
confirms that many lives can be saved through
prevention and early detection The prevention of
cardiovascular diseases also results in significant
savings of our nationrsquos limited health care resources
CDCrsquos Division for Heart Disease and Stroke
Prevention (DHDSP) is committed to having a
positive impact on cardiovascular diseases
The Division for Heart Disease and Stroke Prevention CDC has engaged in heart disease and stroke
prevention work since the late 1980s beginning
with the emergence of the Cardiovascular Health
Studies (CVH) Branch in the National Center for
Chronic Disease Prevention and Health Promotion
(NCCDPHP) In 1998 CDC and the National Institutes
of Health were named co-leaders of the Healthy
People 2010 objectives for heart disease and stroke
In that same year Congress funded CDC to establish
the National Heart Disease and Stroke Prevention
Program which helps build state- and local-level
comprehensive heart disease and stroke programs
In 2001 following the death of Senator Paul
Coverdell from a stroke Congress funded CDC to
establish state stroke registries to capture data that
can be used to measure and improve the quality of
acute stroke care
In 2006 CDC established DHDSP as one of 10
stand-alone divisions within NCCDPHP DHDSP
was created by combining the CVH Branch the
WISEWOMAN program and the office of the
Division of Adult and Community Healthrsquos Associate
Director for CVH Policy and Research WISEWOMAN
provides uninsured women aged 40ndash64 with access
to screening referral and lifestyle interventions to
help reduce their risk for heart disease and other
chronic diseases
DHDSPrsquos mission is to be the nationrsquos public health
leader for achieving cardiovascular health for all and
reducing the burden of disparities in heart disease
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
3
and stroke DHDSP staff collaborate with national
public- and private-sector partners to plan direct
and coordinate programs and research that reduce
risk factors disease deaths and disparities associated
with heart disease and stroke
DHDSP provides national leadership in addressing
key issues such as sodium consumption awareness
of signs and symptoms of heart attack and stroke
and access to screening and interventions for
cardiovascular problems The results of DHDSPrsquos
work are often highlighted in the national media
have gained widespread exposure on the Internet
and have been published in professional and peer-
reviewed journals and publications
The National Forum for Heart Disease and Stroke Prevention CDC the American Heart Association and the
Association of State and Territorial Health Officials
led the development of the landmark publication
A Public Health Action Plan to Prevent Heart
Disease and Stroke (Action Plan) The National
Forum for Heart Disease and Stroke Prevention
was convened to review draft recommendations
for the Action Plan in September 2002 and in
2003 it became a major vehicle for implementing
the plan This national coalition now representing
more than 80 organizations provides strategic
guidance on heart disease and stroke prevention
activities through the Action Plan and promotes
collaboration through an annual meeting held in
Washington DC and face-to-face meetings with
each of its seven implementation work groups The
Action Plan provides states organizations and key
stakeholders with a framework for planning public
health strategies to prevent heart disease and stroke
throughout the nation
DHDSP Goals 1 Prevent risk factors for heart disease and stroke
2 Increase detection and treatment of risk factors
for heart disease and stroke
3 Increase early identification and treatment of heart
disease and stroke
4 Decrease recurrences of cardiovascular events
5 Foster a skilled and engaged public health
workforce to address heart disease and stroke
Organization and Staffing
DHDSP Structure
DHDSP consists of the Office of the Director
(OD) and three branches the Applied Research
and Evaluation Branch (AREB) the Epidemiology
and Surveillance Branch (ESB) and the Program
Development and Services Branch (PDSB)
office of the Director OD is responsible for resource management research
coordination communications partnership building
external affairs coordination of policy and legislative
activities and global collaborations OD staff
participate in and manage activities related to
Division partnerships such as CDCrsquos Cardiovascular
Health Collaboration the National Forum and the
Healthy People 2010 Partnership
Program Development and services Branch PDSB promotes evidence-based strategies and
programs to reduce health disparities and prevent
heart disease and stroke throughout the nation It
funds and manages cooperative agreements with
states tribal organizations and partners and provides
technical assistance to staff in the National Heart
Disease and Stroke Prevention Program PDSB
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
DHDSP Organizational Structure
Office of the Director
Deputy Director Administrative Office
Associate Director for Science
Strategic Planning Partnerships and External Relations
Global Health Coordinator
Epidemiology and Surveillance Branch
Program Development and Services Branch
WISEWOMAN Team
Senior Advisor to Division Director
Applied Research and Evaluation Branch
Planning Partnerships and Policy Team
Health Communication and Program Information Team
Statistical Unit
Epidemiology and Surveillance Team
Small Area Analysis Team
Health Services Research and Registries Team
Program Services Team Applied Research and Translation Team
Evaluation and Program Effectiveness Team
4
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
5
provides grantees with comprehensive technical
assistance training and programmatic tools and
guidance for the development implementation
and evaluation of programs Together with related
programs across NCCDPHP PDSB provides
leadership to ensure collaboration that can affect
heart disease and stroke prevention outcomes
epidemiology and surveillance Branch ESB studies patterns and trends in the following areas
as they relate to cardiovascular diseases risk factors
costs health behaviors and outcomes barriers to
patient access to care public awareness geographic
variation and disparity of cardiovascular disease
rates among races and ethnic groups These scientific
findings allow DHDSP and its partners to respond
to emerging health risks and promote public health
practice ESB funds and manages the Paul Coverdell
National Acute Stroke Registry Staff provide technical
assistance and expertise through scientific articles
research findings geographic information system
mapping and promotion of new surveillance
methods and technologies
applied research and evaluation Branch AREB works with states partners and colleagues to
conduct and translate applied research and evaluation
of heart disease and stroke prevention efforts It
evaluates programs policies and interventions to
ensure they are working as planned and producing
the intended results It promotes evidence-based
practice by translating scientific findings into practical
resources and tools for public health practitioners
health care providers and others working to prevent
heart disease and stroke In addition AREB supports
state program activities through technical assistance
guidance resource development and capacity
building for applied research and evaluation
Funded Programs DHDSP funds and supports three national heart
disease and stroke prevention programs The fiscal
year 2010 appropriation was $56 million for heart
disease and stroke prevention programs Funds
are awarded through a competitive process for
the National Heart Disease and Stroke Prevention
Program Paul Coverdell National Acute Stroke
Registry and Sodium Reduction in Communities
Program
National Heart Disease and Stroke Prevention Program
The National Heart Disease and Stroke Prevention
Program provides funding and support to state
health departments to manage heart disease and
stroke prevention programs at the state and local
levels DHDSP shares the latest science and practices
with states to help reduce disease deaths and
health disparities related to heart disease and stroke
especially among those at high risk The program
has grown from funding 8 states in 1998 to funding
41 states and the District of Columbia in the current
funding cycle Twenty-eight states are funded for
capacity building and 14 for basic implementation
CDC-funded state programs promote changes to
policies and systems in health care worksite and
community settings and the elimination of health
disparities by emphasizing the ABCS of heart
disease and stroke prevention Some programs also
work to improve emergency response and quality
of acute care
WISEWOMAN
The Well-Integrated Screening and Evaluation for
WOMen Across the Nation (WISEWOMAN) Program
helps women with little or no health insurance
access services that can help reduce their risk for
heart disease stroke and other chronic diseases
The priority age group is women aged 40ndash64 years
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
6
2010 Funded Programs
2011 Funded Programs
NHDSP Funded States
WISEWOMAN Programs
WA
MT
ID WY
NV
AK
HI
AZ NM
TX
KSCO
OK
SD
ND
AR
IN OH
KY
TN
LA ALMS
FL
GA
NY
ME
OR
UT
CA
NE IA
MO
WI
IL
MN
MI
VAWV
SC
NC
PA NH
DE
VT
MD
NJ
RI
DC
MA
CT
Coverdell Stroke Registry States
Sodium Reduction Communities
Unfunded States
Note WISEWOMAN funds two tribal organizations in Alaska but not the state health department
Congress authorized the program in 1993 as an
expansion of services offered through the National
Breast and Cervical Cancer Early Detection Program
DHDSP funds WISEWOMAN programs in 19 states
and 2 tribal organizations Working in local clinics
and health care settings WISEWOMAN provides
heart disease and stroke risk factor screenings and
offers lifestyle interventions to help women increase
their physical activity improve their diet and engage
in tobacco cessation efforts
Paul Coverdell National Acute Stroke Registry
DHDSP funds states to establish surveillance systems
that measure track and provide data to help improve
the delivery and quality of stroke care among acute
stroke patients In 2001 Congress funded CDC to
establish the Paul Coverdell National Acute Stroke
Registry after US Senator Paul Coverdell of Georgia
suffered a fatal stroke while serving in Congress
The goal of the Coverdell Registry is to ensure that
all stroke patients receive the highest quality acute
stroke care available to reduce untimely deaths
prevent disability and avoid recurrent strokes With
Coverdell Registry data states and their health care
partners identify and analyze gaps in stroke care
systems and plan targeted strategies to address
them In June 2004 CDC funded four state health
departments (Georgia Illinois Massachusetts
and North Carolina) to establish Paul Coverdell
National Acute Stroke Registries In the most recent
Paul Coverdell National Acute Stroke Registry
funding cycle (2007ndash2011) CDC funded state health
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
7
departments in Georgia Massachusetts Michigan
Minnesota Ohio and North Carolina In 2007
CDC The Joint Commissionrsquos Primary Stroke Center
Certification program and the American Heart
AssociationAmerican Stroke Associationrsquos Get With
The Guidelinesreg-Stroke program jointly released a set
of standardized stroke performance measures to be
used by all three programs This effort has reduced
duplication of effort increased collaboration and
encouraged hospitals to participate in the programs
Office of the Director
Mississippi Delta Health Collaborative (Delta Health Initiative)
The Mississippi Delta Health Collaborative (MDHC)
is designed to prevent heart disease stroke and
related chronic diseases Through a new five-year
cooperative agreement this initiative will intensify
collaboration among the Mississippi Department of
Health existing chronic disease programs (eg heart
disease and stroke prevention diabetes tobacco
nutrition physical activity) local health departments
other community health care providers (eg
federally qualified health centers) local communities
and CDC This result will be achieved through
implementation of interventions across Mississippirsquos
18-county Delta Region The program will target
the ldquoABCSrdquo of heart disease and stroke prevention
among priority populations in high burden
underserved rural areas
bull Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
bull Hemoglobin A1c (HbA1c) Monitor and control
blood glucose
bull Blood pressure Prevent and control high blood
pressure
bull Cholesterol Prevent and control high LDL-
cholesterol
bull Smoking Prevent initiation and increase cessation
of smoking and increase the percentage of the
population protected by smoke-free air laws or
regulations
The Mississippi Department of Health will provide
leadership and funding support in the Delta
Region to implement prioritized population-based
interventions policy systems and environmental
change selected as appropriate from a set of
prescribed evidence-based strategies in both the
clinical and community settings
WISEWOMAN
The WISEWOMAN Program began a new five-
year funding cycle June 30 2008 The competitive
application process resulted in 21 programs being
funded This is an increase of six programs from the
previous funding cycle Seventeen WISEWOMAN
programs also receive funding to implement the
National Heart Disease and Stroke Prevention
Program
One major focus of the funding opportunity
announcement (FOA) is development of partnerships
At a minimum funded programs are expected to
partner with their statetribal Breast and Cervical
Cancer Early Detection Program Tobacco Control
Program Heart Disease and Stroke Prevention
ProgramCoalition and other programs that
can affect policies and environments in which
WISEWOMAN participants live work and play
Because the majority of WISEWOMAN funding must
be spent on providing direct services to women
partnerships are extremely important to ensure
participant access to affordable and quality resources
to support heart health
WISEWOMAN evaluation emphasizes program
improvement and is based on the CDC Framework
for Program Evaluation in Public Health CDC has
developed key evaluation questions related to the
programrsquos stated goals and logic model components
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
8
The questions are used in the evaluation of the
WISEWOMAN Program Funded programs are
required to conduct evaluations to assess progress
toward meeting stated work plan objectives and to
share results with others including their providers
partners other stakeholders and CDC Funded
programs contribute to the WISEWOMAN Program
evaluation by providing Minimum Data Elements
data submitting information to CDC that supports
program evaluation activities and participating in
activities such as site visits and case studies
Sodium Reduction in Communities
High sodium consumption is a major contributor
to high blood pressure a leading cause of stroke
coronary heart disease heart attack and heart and
kidney failure in the United States The 2010 Dietary
Guidelines for Americans recommend limiting
sodium to less than 2300 milligrams (mg) per day
Individuals who are 51 and older and those of any
age who are African American or have hypertension
diabetes or chronic kidney disease should limit
intake to 1500 mg of sodium per day These groups
account for about half the US population and the
majority of adults
Studies show that on average US adults consume
more than 3400 mg of sodium per day An estimated
77 percent of sodium comes from processed and
restaurant foods Reducing dietary intake of sodium
to 2300 mg per day could prevent as many as 11
million cases of hypertension in the United States
Further reductions in sodium intake to 1500 mg per
day could prevent more than 16 million cases
Through the three-year Sodium Reduction in
Communities cooperative agreement which began in
September 2010 DHDSP is providing support to six
communities to support policy changes designed to
create healthier food environments The communities
receiving support include California (Shasta County)
Kansas (Shawnee County) Los Angeles County
New York City and New York State (Broome and
Schenectady counties)
Program Development and Services Branch
Funded State Programs
National Heart Disease and Stroke Prevention Program The enhanced reach of the National
Heart Disease and Stroke Prevention Program was
a key accomplishment in 2008 Eight new states
(Connecticut Hawaii Idaho Iowa Maryland New
Jersey North Dakota and West Virginia) were funded
as part of the program bringing the total number of
funded programs to 42
Leadership to Center Integration PDSB has
provided leadership to NCCDPHPrsquos initiative to
increase synergy reach and desired health outcomes
in selected NCCDPHP-funded categorical programs
(National Heart Disease and Stroke Prevention
Diabetes Prevention and Control Tobacco Control
Comprehensive Cancer Control Nutrition Physical
Activity and Obesity and the Behavioral Risk Factor
Surveillance System)
National Training DHDSP conducted the 2008
National Heart Disease and Stroke Prevention
Training Institute on September 9ndash11 in Atlanta The
training focused on longer skill-building interactive
workshops that addressed the competencies
program priorities and performance measures of
the FOAs for DHDSPrsquos funded programs It included
the National Heart Disease and Stroke Prevention
Program and WISEWOMAN and was expanded to
include representation from each statersquos heart disease
program as well as American Heart Association
field staff working in the states Informal feedback
indicates that the training has already led to greater
collaboration at the state level
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
9
Management Information System (MIS) In 2008
DHDSP completed revisions for the heart disease
and stroke prevention Web-based MIS The report
generated by the system was changed to a table that
displays an objective time frame status and progress
in an easy-to-read format These changes made the
system more user friendly for states and CDC The
MIS can now be used to
bull Describe state program activities and expected
use of CDC funds
bull Track progress on state program activities and
identify promising practices
bull Assist CDC in identifying the need for training
and technical assistance
bull Standardize the state reporting process to
facilitate evaluation
bull Enable CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Funded Partnerships
Directors of Health Promotion and Education
(DHPE) In 2008 DHDSP continued to support
the DHPECDC Internship Program for Students
of Minority Serving Institutions
National Stroke Association DHDSP assisted with
funding for the Sixth Annual National Public Health
Stroke Summit conducted by the National Stroke
Association in Denver Colorado in December 2007
The Summit brought together 105 state public health
and health care professionals to promote information
sharing knowledge and skill building networking
and partnership development
National Collaborations
Cardiovascular Health (CVH) Council of the National Association of Chronic Disease Directors (NACDD) In 2008 the CVH Council
updated its section of the NACDD website to include
additional materials useful to states and it started
a Web discussion forum that allows states to share
ideas and products The Council obtained private
funds and sponsored the 2-day Northeast Regional
Workshop on Cholesterol Control in which 11
states participated in May 2008 It also funded two
of the participating states (Maine and Maryland)
to do follow-up work on cholesterol control with
their primary care associations and local federally
qualified health centers In March 2008 the
Council led the development of a themed issue of
the e-journal Preventing Chronic Disease In most
cases state program staff coauthored articles with
DHDSP staff The CVH Council worked with DHDSP
to assess the training needs of state programs in
the National Heart Disease and Stroke Prevention
Program and DHDSP used this information to plan
its September 2008 3-day training workshop for state
program and WISEWOMAN staff
Epidemiology and Surveillance Branch
Cardiac Arrest Registry to Enhance Survival
The Cardiac Arrest Registry to Enhance Survival
(CARES) began in 2005 in Atlanta and has since
expanded to 40 communities in 23 states CARES is
a simple but robust registry of cardiac arrest events
that allows participating sites to enter data related
to out-of-hospital cardiac arrest (OHCA) generate
summary reports and compare local data with
similar EMS systems elsewhere Three sources of
data are linked to describe each OHCA event 1)
9-1-1 call center data (to provide incident address
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10
and dispatch and arrival times) 2) EMS data (to
describe initially recorded cardiac rhythm and
treatment methods) and 3) hospital data (emergency
department and hospital outcome hypothermia
treatment and neurologic status at discharge)
Multiple reporting features can be generated and
monitored continuously through secure online access
by CARES participants which allows for longitudinal
internal benchmarking Local EMS administrators
and medical directors are able to identify when and
where cardiac arrests occur which elements of their
EMS system are functioning properly in dealing
with these cases and what changes can be made to
improve outcomes In 2011 CARES began expanding
to statewide participation in six states which will
allow additional communities of different sizes and
population densities to be included in the registry In
addition state-level participation will promote better
communication and collaboration between state and
local EMS providers A recent MMWR Surveillance
Summary was published summarizing CARES data
collected during October 1 2005ndashDecember 31
2010 (wwwcdcgovmmwrpdfssss6008pdf) More
information about CARES can be found on the
CARES website at httpsmycaresnet
Paul Coverdell National Acute Stroke Registry
New Registries The Paul Coverdell National
Acute Stroke Registry program successfully
implemented stroke registries in three newly
funded states in 2007 (Michigan Minnesota and
Ohio) These states made much greater progress
in their first year toward developing program
infrastructure collecting data and engaging in
quality improvement activities than had the four
states that completed their first year of Coverdell
Registry funding in 2004 Much of this progress can
be attributed to CDCrsquos increased capacity to provide
proactive technical assistance to states through
conference calls work groups and resource
materials such as the program resource manual
Supplemental Projects The Coverdell Registry
team developed and funded a supplemental
cooperative agreement to pilot the expansion of
the Coverdell Registry model to other domains
within stroke systems of care North Carolina was
funded to demonstrate the feasibility of linking
pre-hospital EMS data for stroke with the state
Coverdell Registry (the North Carolina Stroke
Care Collaborative) In 2010 in partnership with
the Association of State and Territorial Health
Officials CDC funded two Coverdell states to
develop comprehensive statewide stroke care
systems plans CDC is currently funding the Ohio
Coverdell Registry to study 30-day outcomes
of stroke patients based on the quality of care
provided In partnership with the Agency for
Healthcare Research and Quality CDC has funded
an evidence-based review of transitions in care
from hospital to home or rehabilitation for stroke
patients
National Evaluation Plan Through a yearlong
collaboration with RTI International the Coverdell
Registry developed a national evaluation plan The
plan provides a systematic method of assessing
the annual and long-term performance of the
program including strategic goals and objectives
performance goals performance measures and
targets for program outcomes
Consensus Stroke Performance Measures
Endorsement of the Consensus Stroke
Performance Measures The Coverdell Registry
partnered with the American Heart Association
and The Joint Commission to develop performance
measures for acute stroke care commonly
referred to as the Consensus Stroke Performance
Measures These measures were released to
hospitals throughout the United States in fall
2007 In January 2008 more than 1200 hospitals
began using these measures to improve the quality
of care for acute stroke patients The measures
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
11
were submitted to the National Quality Forum in
March 2008 and 8 of the 10 were adopted This
endorsement of the Consensus Stroke Performance
Measures has paved the way for adoption of
these measures by the Centers for Medicare
and Medicaid Services for quality reporting and
meaningful use
Quarterly Data Reports With the implementation
of the Consensus Stroke Performance Measures in
January 2008 CDC began providing states with
quarterly data reports on the measures These
reports provide each state with a summary of its
data on ischemic stroke hemorrhagic stroke and
transient ischemic attacks as well as aggregate data
for all states in the Coverdell Registry program
Applied Research and Evaluation Branch
Building an Economic Evaluation Research Agenda
Based on program needs and research gaps in heart
disease and stroke prevention the Applied Research
and Evaluation Branch developed an agenda to
guide economic research on 1) economic burden
of cardiovascular diseases and cost-effectiveness of
their control 2) economic value of DHDSP-funded
and other state prevention programs 3) CDCrsquos
Internet-based clearinghouse for information on
the economics of cardiovascular diseases and 4)
developing partnerships in economic research to
increase the impact of such research
Stroke Awareness Signs and Symptoms Awareness Campaigns
To provide guidance for state programs a review of
current research on stroke awareness campaigns was
undertaken to identify evidence to support the most
appropriate ways to increase knowledge of signs and
symptoms for stroke the importance of calling 9-1-1
and relationships between the educational campaigns
and outcomes related to awareness of stroke signs
and symptoms
The literature review and synthesis of current
research on stroke awareness campaigns resulted
in the following dissemination activities
bull Development of a fact sheet for state programs on
literature review findings and considerations for
statesrsquo current activities related to stroke awareness
messages including direct education and tools
available to facilitate campaign development
bull Poster presentation at the 2008 National
Conference on Health Communication Marketing
and Media on evaluation guidance for stroke
awareness campaigns The presentation outlined
specific information for states and communities on
how to strengthen the effectiveness and outcome
evaluation of their stroke awareness campaigns
bull Presentation at the 2008 National Heart Disease
and Stroke Prevention Training Institute about
evidence and research on communication and
media campaigns impact considerations of cost
opportunities for partnering and evaluating
results
Comprehensive and Core Indicators
DHDSP released a set of core indicators for
hypertension as part of a comprehensive evidence-
based set of indicators to guide state heart disease
and stroke prevention programs in evaluating their
efforts State health departments received related
key guidance documents training at the National
Heart Disease and Stroke Prevention Training
Institute and a series of follow-up trainings
Indicators are presented in a Consumer Reports
format and rated on multiple dimensions such as
strength of scientific evidence feasibility of data
collection and face validity
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
12
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkitmdash Evaluation Results
CDC worked with the American Institutes for
Research (AIR) to conduct an evaluation of the
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit State health departments
(SHDs) were trained to use the toolkit to promote
state employer-based initiatives on workplace efforts
for heart disease and stroke prevention
From 2005 to 2007 all the SHDs received copies of
the toolkit and were invited to attend training sessions
(one seminar five webinars and three consultations)
To evaluate the usefulness of the toolkit materials
and obtain recommendations two focus groups with
business leaders and Web-based surveys of the SHDs
were conducted In 2006 all 50 states and the District
of Columbia completed the baseline and in 2008 40
states completed the follow-up
Of the 40 SHDs that completed both waves of the
survey the proportion that reported engaging in
employer-based initiatives significantly increased
from 65 percent to 725 percent during the period
examined despite a reported reduction in staff and
limited appropriations About 90 percent of the
SHDs that responded to the 2008 survey are now
working with employers to promote comprehensive
heart disease and stroke prevention programs
disseminate best practices establish employer-
oriented partnerships participate in seminars for
employers and provide business leaders with
resources Partnerships with employer groups or
business coalitions have focused on worksite policy
changes health promotion and education and
worksite surveillance and assessments In parallel
to these experiences the SHDs have increased their
overall level of confidence in their knowledge and
skills Most of the SHDs (61 percent) agreed that
the CDC trainings and consultations helped them
improve their heart disease and stroke prevention
programs and use the toolkit more effectively
Participation in the trainings was positively associated
with engagement in worksite health promotion and
education The SHDs that received federal funding
had significantly higher participation in macro-
marketing activities reaching employers through
business coalitions associations task forces and
champions and were more likely to establish
partnerships with employer groups and government
agencies
The Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit is available at wwwcdc
govdhdsplibrarytoolkitindexhtm
The Branch also provides economics support to
the Division and partners by documenting costs of
cardiovascular diseases and their risk factors and
identifying cost-effective interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
13
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
National Heart Disease and Stroke Prevention Program Overview
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
14
u Blood pressure Prevent and control high blood Program Overview pressure reduce sodium intake
bull In 1998 the US Congress provided funding
for CDC to initiate a national state-based Heart
Disease and Stroke Prevention (HDSP) program in
eight states
bull CDC funds programs in 41 states and the
District of Columbia Twenty-eight are capacity
building (planning) programs and 14 are basic
implementation (intervention) programs
bull Capacity Building Programs Alabama
Alaska Arizona California Colorado Connecticut
District of Columbia Hawaii Idaho Illinois Iowa
Kansas Kentucky Louisiana Maryland Michigan
Minnesota Mississippi Nebraska New Jersey
North Dakota Ohio Oklahoma Oregon Rhode
Island Tennessee Texas and Wisconsin
bull Basic Implementation Programs Arkansas
Florida Georgia Maine Massachusetts Missouri
Montana New York North Carolina South
Carolina Utah Virginia Washington and West
Virginia
National Heart Disease and Stroke Prevention Program Goals bull Enhance state capacity to plan implement track
and sustain population-based interventions to
address heart disease stroke and related risk
factors Focus program efforts on population-
based policy and systems change strategies to
impact the ldquoABCSrdquo of heart disease and stroke
prevention
u Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
u Cholesterol Prevent and control high
cholesterol
u Smoking Increase the number of smokers
counseled to quit and referred to quitlines by
health care workers increase availability of no
or low-cost cessation products and collaborate
with efforts to increase the percentage of the
population protected by smoke-free air laws
and regulations
To a lesser extent state HDSP programs work to
improve emergency response and quality of acute
care systems
State HDSP programs work to eliminate health
disparities in priority populations (ie groups with
increased burden or need based on race ethnicity
gender geography or socioeconomic status) as an
overarching principle
bull Collaborate with chronic disease programs (eg
those focusing on tobacco diabetes physical
inactivity poor nutrition and obesityoverweight)
and partners to develop and integrate population-
based strategies to prevent heart disease and
stroke
bull Promote cardiovascular health in health care
worksite and community settings through policy
and systems changes
bull Identify and evaluate promising practices to
address heart disease and stroke
bull Conduct surveillance of heart disease stroke
and related risk factors
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
15
u
u
Key Responsibilities of State Capacity Building Programs bull Facilitate collaboration with public- and private-
sector partners such as not-for-profit health
agencies health systems organizations emergency
response agencies federally funded health centers
businesses priority population organizations and
voluntary health organizations
bull Document the state burden of heart disease
stroke and related risk factors
bull Develop plans for population-based strategies
for preventing heart disease and stroke among
general and Priority Populations
bull Develop a comprehensive state HDSP plan
bull Develop an HDSP program logic model and
evaluation plan
bull Assess assets and gaps in state policy and systems
related to HDSP in health care worksite and
community settings
Key Responsibilities of State Basic Implementation Programs bull Enhance all capacity-building program activities
bull Implement and evaluate policy systems change
and educational interventions that address the
six HDSP program priority areas in health care
worksite and community settings
bull Provide training and technical assistance to
public health and health care professionals and
partners to support policy and system changes
that will encourage heart disease and stroke
prevention
How CDC Assists State Heart Disease and Stroke Prevention Programs bull Provides training technical assistance and
funding
bull Funds applied research on heart disease and
stroke interventions and elimination of disparities
that is relevant to state programs
bull Identifies and disseminates science-based
promising practices
bull Partners with national organizations to help states
address prevention of heart disease and stroke
bull Facilitates collaborations with other state chronic
disease programs or activities that address risk
factors populations or settings related to heart
disease and stroke prevention and program
priority areas
bull Develops and disseminates publications and tools
such as
u CDCynergy a CD-ROM-based tool for
planning health communication interventions
State Heart Disease and Stroke Prevention
Program Evaluation Framework (wwwcdc
govdhdsplibraryevaluation_framework
indexhtm) a document providing guidance
on systematic ways to measure the success of
public health programs and on logic model
development
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping an
Evaluation Plan (wwwcdcgovDHDSPstate_
programevaluation_guidesevaluation_plan
htm) a document providing guidance on the
development of evaluation activities to help
programs identify required staff time and
resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
16
u
u
u
u
u
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping and
Using a Logic Model (wwwcdcgovDHDSP
state_programevaluation_guideslogic_model
htm) a document providing guidance on
the development and use of logic models as
planning and evaluation tools
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashWriting SMART
Objectives (wwwcdcgovDHDSPstate_
programevaluation_guidessmart_objectives
htm) a document providing guidance to
states on the development of realistic and
measurable objectives
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit (wwwcdcgov
dhdsplibrarytoolkitindexhtm) a document
that provides information materials and
tools that state programs can reference and
distribute to businesses primarily through
employer and professional organizations
Heart Disease and Stroke Interactive Maps
(wwwcdcgovdhdsplibrarymapsstatemaps
htm) which present heart disease and stroke
mortality rates by county for the state racial
ethnic group and gender of the userrsquos choice
A Communication Guide for Policy and
Environmental Change (wwwcdcgovdhdsp
libraryheart_stroke_guideindexhtm) which
includes information references and examples
of communication from state programs and
Stroke Addendum to the Communication
Guide (wwwcdcgovdhdsplibraryheart_
stroke_guideindexhtm)
For additional information please visit the CDC
website at wwwcdcgovdhdsp or contact the
Division for Heart Disease and Stroke Prevention
Program Development and Services Branch at
(770) 488-2424
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
17
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
State Heart Disease and Stroke Prevention Program Funding Opportunity Announcement DP07-704 At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
18
Introduction The Funding Opportunity Announcement
(FOA) DP07-704 At-A-Glance provides important
information to assist programs funded under this
announcement to deliver their program as intended
The At-A-Glance highlights aspects of FOA DP07-704
important for all funded programs including
the following
bull Overview of the National Heart Disease and
Stroke Prevention Program
bull Heart Disease and Stroke Prevention State
Program roles
bull Performance measures for Capacity Building Basic
Implementation Optional Funding for Capacity
Building programs and Stroke Networks
bull Funded program reporting requirements
bull Budgetfunding guidance
bull National and administrative policy requirements
If a program needs a copy of the full document
it should contact its project officer (see Program
Contacts section of the full National Heart Disease
and Stroke Prevention Program Staff Orientation
Manual) to fulfill that request
Section 1 Background In 1998 the US Congress provided funding for
CDC to initiate a national state-based cardiovascular
health program The Senate Appropriations
Committee in 2005 encouraged CDC to create the
Division for Heart Disease and Stroke Prevention and
increased resources enabling CDC to reach 32 of the
50 states and the District of Columbia with funding
for heart disease and stroke prevention As of 2008
the Heart Disease and Stroke Prevention (HDSP)
program funds 41 states and the District of Columbia
As the Division for Heart Disease and Stroke
Prevention developed so did the focus of the State
HDSP Program Focusing on the six program priority
areas (noted below) should impact morbidity and
mortality of these diseases State programs should
increase heart disease and stroke prevention policies
and systems change with the potential to impact
the general population and Priority Populations
(see Prevention Works CDC Strategies for a Heart-
healthy and Stroke-free America wwwCDCgov
dhdsplibrary) For more information on the CDC
State HDSP Program visit wwwcdcgovdhdspState_
programindexhtm
A Public Health Action Plan to Prevent Heart Disease
and Stroke (see wwwCDCgovdhdsplibrary)
documents the multiple intervention opportunities
for preventing heart disease and stroke It is
important to work with partners collaboratively in
leveraging resources to address the multiple risk
factors that are associated with these diseases
Announcement DP07-704 supports program
components considered essential to enhancing
the leadership of state health departments in
heart disease and stroke prevention It provides
for the funding of capacity building and basic
implementation programs as well as projects such as
the Optional Funding for Capacity Building Programs
and Stroke Networks
A capacity building program develops the foundation
for a comprehensive cardiovascular disease prevention
program through such activities as partnership
development definition of the burden and
development of a state plan A basic implementation
program enhances capacity building activities and
implements disseminates and evaluates intervention
activities that address the state plan objectives and the
CDC program priority areas 1ndash6
1 Increase control of high blood pressure primarily
in adults and older adults
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19
2 Increase control of high blood cholesterol
primarily in adults and older adults
3 Increase knowledge of signs and symptoms for
heart attack and stroke and the importance of
calling 9-1-1
4 Improve emergency response
5 Improve quality of heart disease and stroke care
6 Eliminate disparities in terms of race ethnicity
gender geography or socioeconomic status
Optional Funding for Capacity Building Programs
provides support to programs to implement an
evidence-based or promising practice demonstration
project that addresses the CDC program priority
areas 1ndash6
Stroke Networks support a state health department to
increase stroke prevention activities across a group of
three to six contiguous member states with emphasis
on increasing awareness and implementing priority
policy or systems changes across the states
The State HDSP Program is anchored on the
framework of the Socio-ecological Model which
conceptualized the influences of individual
behaviors family and social relationships community
and environmental effects and societal influences
such as policies on health status In order to
promote significant impact for improving the health
of the population interventions should focus on
implementing policy and systems change strategies
that support heart disease and stroke prevention
Policy change can be addressed through a) public
policy (eg establishing certification for hospital-
based stroke centers) or b) organizational policy
(eg businesses providing health benefits plans
that cover preventive services that include blood
pressure control)
System changes are encouraged in three settings
worksites health care and communities An
example of a systems change is when a health
care setting implements electronic records and
patient care management systems that improve the
quality of health care Interventions within systems
are encouraged at the highest level possiblemdashfor
example activities with business coalitions rather
than individual worksites and with managed care
organizations (MCOs) and state medical associations
rather than individual health care sites or physicians
By working at higher levels to affect systems change
states can impact larger segments of the population
Education and awareness efforts to enhance
public understanding and promote actions related
to cardiovascular diseases and the risk factors of
high blood pressure and high cholesterol signs
and symptoms of heart attack and stroke and the
need to call 9-1-1 are also components of capacity
enhancement
An overarching goal of the State HDSP Program
is to address disparities in heart disease and
stroke and the related risk factors using policy and
systems change strategies Based on disparities
(eg raceethnicity gender geographic geography
socioeconomic status) in mortality access to care
or burden of risk factors the State HDSP Program
should identify Priority Populations and implement
interventions to reach those Priority Populations
No one organization will be able to address the
prevention of heart disease and stroke It will require
many organizations working in collaboration if
progress is to be made in accomplishing the Healthy
People 2010 Objectives Collaboration is defined
by the Wilder Foundation as ldquoa mutually beneficial
and well-defined relationship entered into by two
or more organizations to achieve common goals
The relationship includes a commitment to mutual
relationships and goals a jointly developed structure
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20
and shared responsibility mutual authority and
accountability for success and sharing of resources
and rewardsrdquo Developing and maintaining
strategic partnerships are key to the leveraging of
skills and resources to prevent heart disease and
stroke in a comprehensive way The State HDSP
Program has two major roles related to partners
The first is to convene or facilitate collaboration
to develop and implement a comprehensive state
plan and intervention implementation strategies
that addresses heart disease stroke and related
risk factors The second is to develop strategies to
leverage resources and coordinate interventions
with partners that address the six program
priority areas
A logic model has been developed to describe
the State HDSP Program as intended by the CDC
funding to state health departments (see following
page) The model depicts relationships and actions
(eg links between environment and policy
change and individual-level behavioral change)
that are expected to culminate in reduction in
heart disease and stroke
The CDC and state activities are outlined in terms
of capacity building surveillancemonitoring
and interventions Both CDC and state activities
influence changes that lead to short-term
outcomes such as development of a work plan
and strategies for system-level changes effective
implementation of interventions and action by
target audiences and change agents (those who are
in the position to influence policies and systems
such as hospital administrators and MCO decision
makers) These activities and outcomes result in
changes in policy and environmental supports
which in turn influence behavior changes and
improve health status Ultimately these changes
decrease premature death and disability and
eliminate cardiovascular disparities between
general and Priority Populations
The State HDSP logic model also is a tool to guide
program evaluation By identifying the steps
necessary to reach intended outcomes the logic
model provides guidance in evaluating the short and
intermediate outcomes of the program
State evaluation efforts should relate to the National
HDSP Program logic model or to a logic model that
the state develops that complements the national
model and the required program recipient activities
The logic model can also be seen in the CDC
Evaluation Framework for Heart Disease and Stroke
Prevention State Programs at wwwcdcgovdhdsp
Section 2 National Heart Disease and Stroke Prevention State Program Roles In A Public Health Action Plan to Prevent Heart
Disease and Stroke there are four major goals which
are based on Healthy People 2010
Goal 1 Prevention of risk factors
Goal 2 Detection and treatment of risk factors
Goal 3 Early identification and treatment of heart
attacks and strokes
Goal 4 Prevention of recurrent cardiovascular events
CDC-funded State HDSP Programs have a direct
impact on Goals 2 3 and 4 by addressing HDSP
program priority areas 1ndash6 (see Background section)
HDSP programs have a supportive role with other
state health department programs and partners in
addressing Goal 1 Efforts to address Goal 1 related
to tobacco use diabetes obesity poor nutrition
physical inactivity and schools as a worksite should
be done through a supportive or collaborative role
with the state WISEWOMAN diabetes tobacco
nutrition physical activity or coordinated school
health programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
bull State HDSP Programs are encouraged to
coordinate with other programs in ways that
1 Address Goal 1 (eg State HDSP and Nutrition
Programs identify primary prevention messages
related to cholesterol and salt to be included in Nushy
trition Programs where appropriate State HDSP and
Tobacco Programs collaborate to promote use of
state tobacco quit lines State HDSP Program refers
managed care organizations to materials developed
by the Parks and Recreation Department and
Physical Activity Program on safe places to exercise
National HDSP Program Logic Model
State HDSP and WISEWOMAN Programs collaborate
to create systems for educating health care providers
on guidelines focused on risk factor prevention)
2 Enhance inclusion of key messages in the work
of related programs (eg State HDSP Program
works to implement JNC7 guidelines which
include referral to nutrition counseling the
WISEWOMAN Program incorporates education on
signs and symptoms of heart disease and stroke
into ongoing activities the State HDSP Program
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and system change supports
Level bull State bull Local
Settings bull Community bull Health care bull Worksite
Context bull Priority
Populations bull General
populations
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective intervention
implemented focused on
settings and Priority Populations
Change agents
take action
Activate intended audiences
Capa
city B
uildin
gSu
rveil
lance
Inter
vent
ions
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
21
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
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23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
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25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
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26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
i
Table of Contents
Division for Heart Disease and Stroke Prevention Background and Overview1
National Heart Disease and Stroke Prevention Program Overview 13
State Heart Disease and Stroke Prevention Program Funding
Opportunity Announcement DP07-704 At-A-Glance 17
Management Information System (MIS) At-A-Glance 29
Guidelines for Budget Preparation 32
Program Evaluation Guidance 41
Appendix Websites Publications and Tools 51
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Background and Overview
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
2
The Burden of Heart Disease and Stroke Heart disease and stroke the first and third leading
causes of death for men and women are among the
most widespread and costly health problems facing
our nation today An estimated 935000 heart attacks
and 795000 strokes occur each year One in four
deaths is caused by heart disease and someone dies
of a stroke on average every four minutes Heart
disease and stroke also are among the leading causes
of disability in the United States Nearly 4 million
people report disability from these causes
Death rates alone cannot describe the burden of
heart disease and stroke In 2010 the total costs of
cardiovascular diseases which include heart disease
and stroke were estimated to be $444 billion
Treatment of these diseases accounts for about $1
of every $6 spent on health care in this country As
the US population ages the economic impact of
cardiovascular diseases on our nationrsquos health care
system will become even greater
Overall death rates for heart disease and stroke have
decreased in the United States in recent decades
However rates for incidence and death continue
to be high especially among some populations
including members of certain racial and ethnic
groups people with low socioeconomic status and
those living in the southeastern United States For
example the risk of having a first-ever stroke is
nearly two times higher among African Americans
than among whites In addition about 55000 more
women than men have a stroke each year Recent
studies show that the prevalence of heart disease and
the percentage of associated premature deaths are
higher among American Indians and Alaska Natives
than among any other US racial or ethnic group
The news is not all bad however Scientific evidence
confirms that many lives can be saved through
prevention and early detection The prevention of
cardiovascular diseases also results in significant
savings of our nationrsquos limited health care resources
CDCrsquos Division for Heart Disease and Stroke
Prevention (DHDSP) is committed to having a
positive impact on cardiovascular diseases
The Division for Heart Disease and Stroke Prevention CDC has engaged in heart disease and stroke
prevention work since the late 1980s beginning
with the emergence of the Cardiovascular Health
Studies (CVH) Branch in the National Center for
Chronic Disease Prevention and Health Promotion
(NCCDPHP) In 1998 CDC and the National Institutes
of Health were named co-leaders of the Healthy
People 2010 objectives for heart disease and stroke
In that same year Congress funded CDC to establish
the National Heart Disease and Stroke Prevention
Program which helps build state- and local-level
comprehensive heart disease and stroke programs
In 2001 following the death of Senator Paul
Coverdell from a stroke Congress funded CDC to
establish state stroke registries to capture data that
can be used to measure and improve the quality of
acute stroke care
In 2006 CDC established DHDSP as one of 10
stand-alone divisions within NCCDPHP DHDSP
was created by combining the CVH Branch the
WISEWOMAN program and the office of the
Division of Adult and Community Healthrsquos Associate
Director for CVH Policy and Research WISEWOMAN
provides uninsured women aged 40ndash64 with access
to screening referral and lifestyle interventions to
help reduce their risk for heart disease and other
chronic diseases
DHDSPrsquos mission is to be the nationrsquos public health
leader for achieving cardiovascular health for all and
reducing the burden of disparities in heart disease
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
3
and stroke DHDSP staff collaborate with national
public- and private-sector partners to plan direct
and coordinate programs and research that reduce
risk factors disease deaths and disparities associated
with heart disease and stroke
DHDSP provides national leadership in addressing
key issues such as sodium consumption awareness
of signs and symptoms of heart attack and stroke
and access to screening and interventions for
cardiovascular problems The results of DHDSPrsquos
work are often highlighted in the national media
have gained widespread exposure on the Internet
and have been published in professional and peer-
reviewed journals and publications
The National Forum for Heart Disease and Stroke Prevention CDC the American Heart Association and the
Association of State and Territorial Health Officials
led the development of the landmark publication
A Public Health Action Plan to Prevent Heart
Disease and Stroke (Action Plan) The National
Forum for Heart Disease and Stroke Prevention
was convened to review draft recommendations
for the Action Plan in September 2002 and in
2003 it became a major vehicle for implementing
the plan This national coalition now representing
more than 80 organizations provides strategic
guidance on heart disease and stroke prevention
activities through the Action Plan and promotes
collaboration through an annual meeting held in
Washington DC and face-to-face meetings with
each of its seven implementation work groups The
Action Plan provides states organizations and key
stakeholders with a framework for planning public
health strategies to prevent heart disease and stroke
throughout the nation
DHDSP Goals 1 Prevent risk factors for heart disease and stroke
2 Increase detection and treatment of risk factors
for heart disease and stroke
3 Increase early identification and treatment of heart
disease and stroke
4 Decrease recurrences of cardiovascular events
5 Foster a skilled and engaged public health
workforce to address heart disease and stroke
Organization and Staffing
DHDSP Structure
DHDSP consists of the Office of the Director
(OD) and three branches the Applied Research
and Evaluation Branch (AREB) the Epidemiology
and Surveillance Branch (ESB) and the Program
Development and Services Branch (PDSB)
office of the Director OD is responsible for resource management research
coordination communications partnership building
external affairs coordination of policy and legislative
activities and global collaborations OD staff
participate in and manage activities related to
Division partnerships such as CDCrsquos Cardiovascular
Health Collaboration the National Forum and the
Healthy People 2010 Partnership
Program Development and services Branch PDSB promotes evidence-based strategies and
programs to reduce health disparities and prevent
heart disease and stroke throughout the nation It
funds and manages cooperative agreements with
states tribal organizations and partners and provides
technical assistance to staff in the National Heart
Disease and Stroke Prevention Program PDSB
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
DHDSP Organizational Structure
Office of the Director
Deputy Director Administrative Office
Associate Director for Science
Strategic Planning Partnerships and External Relations
Global Health Coordinator
Epidemiology and Surveillance Branch
Program Development and Services Branch
WISEWOMAN Team
Senior Advisor to Division Director
Applied Research and Evaluation Branch
Planning Partnerships and Policy Team
Health Communication and Program Information Team
Statistical Unit
Epidemiology and Surveillance Team
Small Area Analysis Team
Health Services Research and Registries Team
Program Services Team Applied Research and Translation Team
Evaluation and Program Effectiveness Team
4
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
5
provides grantees with comprehensive technical
assistance training and programmatic tools and
guidance for the development implementation
and evaluation of programs Together with related
programs across NCCDPHP PDSB provides
leadership to ensure collaboration that can affect
heart disease and stroke prevention outcomes
epidemiology and surveillance Branch ESB studies patterns and trends in the following areas
as they relate to cardiovascular diseases risk factors
costs health behaviors and outcomes barriers to
patient access to care public awareness geographic
variation and disparity of cardiovascular disease
rates among races and ethnic groups These scientific
findings allow DHDSP and its partners to respond
to emerging health risks and promote public health
practice ESB funds and manages the Paul Coverdell
National Acute Stroke Registry Staff provide technical
assistance and expertise through scientific articles
research findings geographic information system
mapping and promotion of new surveillance
methods and technologies
applied research and evaluation Branch AREB works with states partners and colleagues to
conduct and translate applied research and evaluation
of heart disease and stroke prevention efforts It
evaluates programs policies and interventions to
ensure they are working as planned and producing
the intended results It promotes evidence-based
practice by translating scientific findings into practical
resources and tools for public health practitioners
health care providers and others working to prevent
heart disease and stroke In addition AREB supports
state program activities through technical assistance
guidance resource development and capacity
building for applied research and evaluation
Funded Programs DHDSP funds and supports three national heart
disease and stroke prevention programs The fiscal
year 2010 appropriation was $56 million for heart
disease and stroke prevention programs Funds
are awarded through a competitive process for
the National Heart Disease and Stroke Prevention
Program Paul Coverdell National Acute Stroke
Registry and Sodium Reduction in Communities
Program
National Heart Disease and Stroke Prevention Program
The National Heart Disease and Stroke Prevention
Program provides funding and support to state
health departments to manage heart disease and
stroke prevention programs at the state and local
levels DHDSP shares the latest science and practices
with states to help reduce disease deaths and
health disparities related to heart disease and stroke
especially among those at high risk The program
has grown from funding 8 states in 1998 to funding
41 states and the District of Columbia in the current
funding cycle Twenty-eight states are funded for
capacity building and 14 for basic implementation
CDC-funded state programs promote changes to
policies and systems in health care worksite and
community settings and the elimination of health
disparities by emphasizing the ABCS of heart
disease and stroke prevention Some programs also
work to improve emergency response and quality
of acute care
WISEWOMAN
The Well-Integrated Screening and Evaluation for
WOMen Across the Nation (WISEWOMAN) Program
helps women with little or no health insurance
access services that can help reduce their risk for
heart disease stroke and other chronic diseases
The priority age group is women aged 40ndash64 years
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
6
2010 Funded Programs
2011 Funded Programs
NHDSP Funded States
WISEWOMAN Programs
WA
MT
ID WY
NV
AK
HI
AZ NM
TX
KSCO
OK
SD
ND
AR
IN OH
KY
TN
LA ALMS
FL
GA
NY
ME
OR
UT
CA
NE IA
MO
WI
IL
MN
MI
VAWV
SC
NC
PA NH
DE
VT
MD
NJ
RI
DC
MA
CT
Coverdell Stroke Registry States
Sodium Reduction Communities
Unfunded States
Note WISEWOMAN funds two tribal organizations in Alaska but not the state health department
Congress authorized the program in 1993 as an
expansion of services offered through the National
Breast and Cervical Cancer Early Detection Program
DHDSP funds WISEWOMAN programs in 19 states
and 2 tribal organizations Working in local clinics
and health care settings WISEWOMAN provides
heart disease and stroke risk factor screenings and
offers lifestyle interventions to help women increase
their physical activity improve their diet and engage
in tobacco cessation efforts
Paul Coverdell National Acute Stroke Registry
DHDSP funds states to establish surveillance systems
that measure track and provide data to help improve
the delivery and quality of stroke care among acute
stroke patients In 2001 Congress funded CDC to
establish the Paul Coverdell National Acute Stroke
Registry after US Senator Paul Coverdell of Georgia
suffered a fatal stroke while serving in Congress
The goal of the Coverdell Registry is to ensure that
all stroke patients receive the highest quality acute
stroke care available to reduce untimely deaths
prevent disability and avoid recurrent strokes With
Coverdell Registry data states and their health care
partners identify and analyze gaps in stroke care
systems and plan targeted strategies to address
them In June 2004 CDC funded four state health
departments (Georgia Illinois Massachusetts
and North Carolina) to establish Paul Coverdell
National Acute Stroke Registries In the most recent
Paul Coverdell National Acute Stroke Registry
funding cycle (2007ndash2011) CDC funded state health
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
7
departments in Georgia Massachusetts Michigan
Minnesota Ohio and North Carolina In 2007
CDC The Joint Commissionrsquos Primary Stroke Center
Certification program and the American Heart
AssociationAmerican Stroke Associationrsquos Get With
The Guidelinesreg-Stroke program jointly released a set
of standardized stroke performance measures to be
used by all three programs This effort has reduced
duplication of effort increased collaboration and
encouraged hospitals to participate in the programs
Office of the Director
Mississippi Delta Health Collaborative (Delta Health Initiative)
The Mississippi Delta Health Collaborative (MDHC)
is designed to prevent heart disease stroke and
related chronic diseases Through a new five-year
cooperative agreement this initiative will intensify
collaboration among the Mississippi Department of
Health existing chronic disease programs (eg heart
disease and stroke prevention diabetes tobacco
nutrition physical activity) local health departments
other community health care providers (eg
federally qualified health centers) local communities
and CDC This result will be achieved through
implementation of interventions across Mississippirsquos
18-county Delta Region The program will target
the ldquoABCSrdquo of heart disease and stroke prevention
among priority populations in high burden
underserved rural areas
bull Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
bull Hemoglobin A1c (HbA1c) Monitor and control
blood glucose
bull Blood pressure Prevent and control high blood
pressure
bull Cholesterol Prevent and control high LDL-
cholesterol
bull Smoking Prevent initiation and increase cessation
of smoking and increase the percentage of the
population protected by smoke-free air laws or
regulations
The Mississippi Department of Health will provide
leadership and funding support in the Delta
Region to implement prioritized population-based
interventions policy systems and environmental
change selected as appropriate from a set of
prescribed evidence-based strategies in both the
clinical and community settings
WISEWOMAN
The WISEWOMAN Program began a new five-
year funding cycle June 30 2008 The competitive
application process resulted in 21 programs being
funded This is an increase of six programs from the
previous funding cycle Seventeen WISEWOMAN
programs also receive funding to implement the
National Heart Disease and Stroke Prevention
Program
One major focus of the funding opportunity
announcement (FOA) is development of partnerships
At a minimum funded programs are expected to
partner with their statetribal Breast and Cervical
Cancer Early Detection Program Tobacco Control
Program Heart Disease and Stroke Prevention
ProgramCoalition and other programs that
can affect policies and environments in which
WISEWOMAN participants live work and play
Because the majority of WISEWOMAN funding must
be spent on providing direct services to women
partnerships are extremely important to ensure
participant access to affordable and quality resources
to support heart health
WISEWOMAN evaluation emphasizes program
improvement and is based on the CDC Framework
for Program Evaluation in Public Health CDC has
developed key evaluation questions related to the
programrsquos stated goals and logic model components
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
8
The questions are used in the evaluation of the
WISEWOMAN Program Funded programs are
required to conduct evaluations to assess progress
toward meeting stated work plan objectives and to
share results with others including their providers
partners other stakeholders and CDC Funded
programs contribute to the WISEWOMAN Program
evaluation by providing Minimum Data Elements
data submitting information to CDC that supports
program evaluation activities and participating in
activities such as site visits and case studies
Sodium Reduction in Communities
High sodium consumption is a major contributor
to high blood pressure a leading cause of stroke
coronary heart disease heart attack and heart and
kidney failure in the United States The 2010 Dietary
Guidelines for Americans recommend limiting
sodium to less than 2300 milligrams (mg) per day
Individuals who are 51 and older and those of any
age who are African American or have hypertension
diabetes or chronic kidney disease should limit
intake to 1500 mg of sodium per day These groups
account for about half the US population and the
majority of adults
Studies show that on average US adults consume
more than 3400 mg of sodium per day An estimated
77 percent of sodium comes from processed and
restaurant foods Reducing dietary intake of sodium
to 2300 mg per day could prevent as many as 11
million cases of hypertension in the United States
Further reductions in sodium intake to 1500 mg per
day could prevent more than 16 million cases
Through the three-year Sodium Reduction in
Communities cooperative agreement which began in
September 2010 DHDSP is providing support to six
communities to support policy changes designed to
create healthier food environments The communities
receiving support include California (Shasta County)
Kansas (Shawnee County) Los Angeles County
New York City and New York State (Broome and
Schenectady counties)
Program Development and Services Branch
Funded State Programs
National Heart Disease and Stroke Prevention Program The enhanced reach of the National
Heart Disease and Stroke Prevention Program was
a key accomplishment in 2008 Eight new states
(Connecticut Hawaii Idaho Iowa Maryland New
Jersey North Dakota and West Virginia) were funded
as part of the program bringing the total number of
funded programs to 42
Leadership to Center Integration PDSB has
provided leadership to NCCDPHPrsquos initiative to
increase synergy reach and desired health outcomes
in selected NCCDPHP-funded categorical programs
(National Heart Disease and Stroke Prevention
Diabetes Prevention and Control Tobacco Control
Comprehensive Cancer Control Nutrition Physical
Activity and Obesity and the Behavioral Risk Factor
Surveillance System)
National Training DHDSP conducted the 2008
National Heart Disease and Stroke Prevention
Training Institute on September 9ndash11 in Atlanta The
training focused on longer skill-building interactive
workshops that addressed the competencies
program priorities and performance measures of
the FOAs for DHDSPrsquos funded programs It included
the National Heart Disease and Stroke Prevention
Program and WISEWOMAN and was expanded to
include representation from each statersquos heart disease
program as well as American Heart Association
field staff working in the states Informal feedback
indicates that the training has already led to greater
collaboration at the state level
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
9
Management Information System (MIS) In 2008
DHDSP completed revisions for the heart disease
and stroke prevention Web-based MIS The report
generated by the system was changed to a table that
displays an objective time frame status and progress
in an easy-to-read format These changes made the
system more user friendly for states and CDC The
MIS can now be used to
bull Describe state program activities and expected
use of CDC funds
bull Track progress on state program activities and
identify promising practices
bull Assist CDC in identifying the need for training
and technical assistance
bull Standardize the state reporting process to
facilitate evaluation
bull Enable CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Funded Partnerships
Directors of Health Promotion and Education
(DHPE) In 2008 DHDSP continued to support
the DHPECDC Internship Program for Students
of Minority Serving Institutions
National Stroke Association DHDSP assisted with
funding for the Sixth Annual National Public Health
Stroke Summit conducted by the National Stroke
Association in Denver Colorado in December 2007
The Summit brought together 105 state public health
and health care professionals to promote information
sharing knowledge and skill building networking
and partnership development
National Collaborations
Cardiovascular Health (CVH) Council of the National Association of Chronic Disease Directors (NACDD) In 2008 the CVH Council
updated its section of the NACDD website to include
additional materials useful to states and it started
a Web discussion forum that allows states to share
ideas and products The Council obtained private
funds and sponsored the 2-day Northeast Regional
Workshop on Cholesterol Control in which 11
states participated in May 2008 It also funded two
of the participating states (Maine and Maryland)
to do follow-up work on cholesterol control with
their primary care associations and local federally
qualified health centers In March 2008 the
Council led the development of a themed issue of
the e-journal Preventing Chronic Disease In most
cases state program staff coauthored articles with
DHDSP staff The CVH Council worked with DHDSP
to assess the training needs of state programs in
the National Heart Disease and Stroke Prevention
Program and DHDSP used this information to plan
its September 2008 3-day training workshop for state
program and WISEWOMAN staff
Epidemiology and Surveillance Branch
Cardiac Arrest Registry to Enhance Survival
The Cardiac Arrest Registry to Enhance Survival
(CARES) began in 2005 in Atlanta and has since
expanded to 40 communities in 23 states CARES is
a simple but robust registry of cardiac arrest events
that allows participating sites to enter data related
to out-of-hospital cardiac arrest (OHCA) generate
summary reports and compare local data with
similar EMS systems elsewhere Three sources of
data are linked to describe each OHCA event 1)
9-1-1 call center data (to provide incident address
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
10
and dispatch and arrival times) 2) EMS data (to
describe initially recorded cardiac rhythm and
treatment methods) and 3) hospital data (emergency
department and hospital outcome hypothermia
treatment and neurologic status at discharge)
Multiple reporting features can be generated and
monitored continuously through secure online access
by CARES participants which allows for longitudinal
internal benchmarking Local EMS administrators
and medical directors are able to identify when and
where cardiac arrests occur which elements of their
EMS system are functioning properly in dealing
with these cases and what changes can be made to
improve outcomes In 2011 CARES began expanding
to statewide participation in six states which will
allow additional communities of different sizes and
population densities to be included in the registry In
addition state-level participation will promote better
communication and collaboration between state and
local EMS providers A recent MMWR Surveillance
Summary was published summarizing CARES data
collected during October 1 2005ndashDecember 31
2010 (wwwcdcgovmmwrpdfssss6008pdf) More
information about CARES can be found on the
CARES website at httpsmycaresnet
Paul Coverdell National Acute Stroke Registry
New Registries The Paul Coverdell National
Acute Stroke Registry program successfully
implemented stroke registries in three newly
funded states in 2007 (Michigan Minnesota and
Ohio) These states made much greater progress
in their first year toward developing program
infrastructure collecting data and engaging in
quality improvement activities than had the four
states that completed their first year of Coverdell
Registry funding in 2004 Much of this progress can
be attributed to CDCrsquos increased capacity to provide
proactive technical assistance to states through
conference calls work groups and resource
materials such as the program resource manual
Supplemental Projects The Coverdell Registry
team developed and funded a supplemental
cooperative agreement to pilot the expansion of
the Coverdell Registry model to other domains
within stroke systems of care North Carolina was
funded to demonstrate the feasibility of linking
pre-hospital EMS data for stroke with the state
Coverdell Registry (the North Carolina Stroke
Care Collaborative) In 2010 in partnership with
the Association of State and Territorial Health
Officials CDC funded two Coverdell states to
develop comprehensive statewide stroke care
systems plans CDC is currently funding the Ohio
Coverdell Registry to study 30-day outcomes
of stroke patients based on the quality of care
provided In partnership with the Agency for
Healthcare Research and Quality CDC has funded
an evidence-based review of transitions in care
from hospital to home or rehabilitation for stroke
patients
National Evaluation Plan Through a yearlong
collaboration with RTI International the Coverdell
Registry developed a national evaluation plan The
plan provides a systematic method of assessing
the annual and long-term performance of the
program including strategic goals and objectives
performance goals performance measures and
targets for program outcomes
Consensus Stroke Performance Measures
Endorsement of the Consensus Stroke
Performance Measures The Coverdell Registry
partnered with the American Heart Association
and The Joint Commission to develop performance
measures for acute stroke care commonly
referred to as the Consensus Stroke Performance
Measures These measures were released to
hospitals throughout the United States in fall
2007 In January 2008 more than 1200 hospitals
began using these measures to improve the quality
of care for acute stroke patients The measures
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
11
were submitted to the National Quality Forum in
March 2008 and 8 of the 10 were adopted This
endorsement of the Consensus Stroke Performance
Measures has paved the way for adoption of
these measures by the Centers for Medicare
and Medicaid Services for quality reporting and
meaningful use
Quarterly Data Reports With the implementation
of the Consensus Stroke Performance Measures in
January 2008 CDC began providing states with
quarterly data reports on the measures These
reports provide each state with a summary of its
data on ischemic stroke hemorrhagic stroke and
transient ischemic attacks as well as aggregate data
for all states in the Coverdell Registry program
Applied Research and Evaluation Branch
Building an Economic Evaluation Research Agenda
Based on program needs and research gaps in heart
disease and stroke prevention the Applied Research
and Evaluation Branch developed an agenda to
guide economic research on 1) economic burden
of cardiovascular diseases and cost-effectiveness of
their control 2) economic value of DHDSP-funded
and other state prevention programs 3) CDCrsquos
Internet-based clearinghouse for information on
the economics of cardiovascular diseases and 4)
developing partnerships in economic research to
increase the impact of such research
Stroke Awareness Signs and Symptoms Awareness Campaigns
To provide guidance for state programs a review of
current research on stroke awareness campaigns was
undertaken to identify evidence to support the most
appropriate ways to increase knowledge of signs and
symptoms for stroke the importance of calling 9-1-1
and relationships between the educational campaigns
and outcomes related to awareness of stroke signs
and symptoms
The literature review and synthesis of current
research on stroke awareness campaigns resulted
in the following dissemination activities
bull Development of a fact sheet for state programs on
literature review findings and considerations for
statesrsquo current activities related to stroke awareness
messages including direct education and tools
available to facilitate campaign development
bull Poster presentation at the 2008 National
Conference on Health Communication Marketing
and Media on evaluation guidance for stroke
awareness campaigns The presentation outlined
specific information for states and communities on
how to strengthen the effectiveness and outcome
evaluation of their stroke awareness campaigns
bull Presentation at the 2008 National Heart Disease
and Stroke Prevention Training Institute about
evidence and research on communication and
media campaigns impact considerations of cost
opportunities for partnering and evaluating
results
Comprehensive and Core Indicators
DHDSP released a set of core indicators for
hypertension as part of a comprehensive evidence-
based set of indicators to guide state heart disease
and stroke prevention programs in evaluating their
efforts State health departments received related
key guidance documents training at the National
Heart Disease and Stroke Prevention Training
Institute and a series of follow-up trainings
Indicators are presented in a Consumer Reports
format and rated on multiple dimensions such as
strength of scientific evidence feasibility of data
collection and face validity
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
12
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkitmdash Evaluation Results
CDC worked with the American Institutes for
Research (AIR) to conduct an evaluation of the
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit State health departments
(SHDs) were trained to use the toolkit to promote
state employer-based initiatives on workplace efforts
for heart disease and stroke prevention
From 2005 to 2007 all the SHDs received copies of
the toolkit and were invited to attend training sessions
(one seminar five webinars and three consultations)
To evaluate the usefulness of the toolkit materials
and obtain recommendations two focus groups with
business leaders and Web-based surveys of the SHDs
were conducted In 2006 all 50 states and the District
of Columbia completed the baseline and in 2008 40
states completed the follow-up
Of the 40 SHDs that completed both waves of the
survey the proportion that reported engaging in
employer-based initiatives significantly increased
from 65 percent to 725 percent during the period
examined despite a reported reduction in staff and
limited appropriations About 90 percent of the
SHDs that responded to the 2008 survey are now
working with employers to promote comprehensive
heart disease and stroke prevention programs
disseminate best practices establish employer-
oriented partnerships participate in seminars for
employers and provide business leaders with
resources Partnerships with employer groups or
business coalitions have focused on worksite policy
changes health promotion and education and
worksite surveillance and assessments In parallel
to these experiences the SHDs have increased their
overall level of confidence in their knowledge and
skills Most of the SHDs (61 percent) agreed that
the CDC trainings and consultations helped them
improve their heart disease and stroke prevention
programs and use the toolkit more effectively
Participation in the trainings was positively associated
with engagement in worksite health promotion and
education The SHDs that received federal funding
had significantly higher participation in macro-
marketing activities reaching employers through
business coalitions associations task forces and
champions and were more likely to establish
partnerships with employer groups and government
agencies
The Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit is available at wwwcdc
govdhdsplibrarytoolkitindexhtm
The Branch also provides economics support to
the Division and partners by documenting costs of
cardiovascular diseases and their risk factors and
identifying cost-effective interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
13
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
National Heart Disease and Stroke Prevention Program Overview
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
14
u Blood pressure Prevent and control high blood Program Overview pressure reduce sodium intake
bull In 1998 the US Congress provided funding
for CDC to initiate a national state-based Heart
Disease and Stroke Prevention (HDSP) program in
eight states
bull CDC funds programs in 41 states and the
District of Columbia Twenty-eight are capacity
building (planning) programs and 14 are basic
implementation (intervention) programs
bull Capacity Building Programs Alabama
Alaska Arizona California Colorado Connecticut
District of Columbia Hawaii Idaho Illinois Iowa
Kansas Kentucky Louisiana Maryland Michigan
Minnesota Mississippi Nebraska New Jersey
North Dakota Ohio Oklahoma Oregon Rhode
Island Tennessee Texas and Wisconsin
bull Basic Implementation Programs Arkansas
Florida Georgia Maine Massachusetts Missouri
Montana New York North Carolina South
Carolina Utah Virginia Washington and West
Virginia
National Heart Disease and Stroke Prevention Program Goals bull Enhance state capacity to plan implement track
and sustain population-based interventions to
address heart disease stroke and related risk
factors Focus program efforts on population-
based policy and systems change strategies to
impact the ldquoABCSrdquo of heart disease and stroke
prevention
u Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
u Cholesterol Prevent and control high
cholesterol
u Smoking Increase the number of smokers
counseled to quit and referred to quitlines by
health care workers increase availability of no
or low-cost cessation products and collaborate
with efforts to increase the percentage of the
population protected by smoke-free air laws
and regulations
To a lesser extent state HDSP programs work to
improve emergency response and quality of acute
care systems
State HDSP programs work to eliminate health
disparities in priority populations (ie groups with
increased burden or need based on race ethnicity
gender geography or socioeconomic status) as an
overarching principle
bull Collaborate with chronic disease programs (eg
those focusing on tobacco diabetes physical
inactivity poor nutrition and obesityoverweight)
and partners to develop and integrate population-
based strategies to prevent heart disease and
stroke
bull Promote cardiovascular health in health care
worksite and community settings through policy
and systems changes
bull Identify and evaluate promising practices to
address heart disease and stroke
bull Conduct surveillance of heart disease stroke
and related risk factors
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
15
u
u
Key Responsibilities of State Capacity Building Programs bull Facilitate collaboration with public- and private-
sector partners such as not-for-profit health
agencies health systems organizations emergency
response agencies federally funded health centers
businesses priority population organizations and
voluntary health organizations
bull Document the state burden of heart disease
stroke and related risk factors
bull Develop plans for population-based strategies
for preventing heart disease and stroke among
general and Priority Populations
bull Develop a comprehensive state HDSP plan
bull Develop an HDSP program logic model and
evaluation plan
bull Assess assets and gaps in state policy and systems
related to HDSP in health care worksite and
community settings
Key Responsibilities of State Basic Implementation Programs bull Enhance all capacity-building program activities
bull Implement and evaluate policy systems change
and educational interventions that address the
six HDSP program priority areas in health care
worksite and community settings
bull Provide training and technical assistance to
public health and health care professionals and
partners to support policy and system changes
that will encourage heart disease and stroke
prevention
How CDC Assists State Heart Disease and Stroke Prevention Programs bull Provides training technical assistance and
funding
bull Funds applied research on heart disease and
stroke interventions and elimination of disparities
that is relevant to state programs
bull Identifies and disseminates science-based
promising practices
bull Partners with national organizations to help states
address prevention of heart disease and stroke
bull Facilitates collaborations with other state chronic
disease programs or activities that address risk
factors populations or settings related to heart
disease and stroke prevention and program
priority areas
bull Develops and disseminates publications and tools
such as
u CDCynergy a CD-ROM-based tool for
planning health communication interventions
State Heart Disease and Stroke Prevention
Program Evaluation Framework (wwwcdc
govdhdsplibraryevaluation_framework
indexhtm) a document providing guidance
on systematic ways to measure the success of
public health programs and on logic model
development
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping an
Evaluation Plan (wwwcdcgovDHDSPstate_
programevaluation_guidesevaluation_plan
htm) a document providing guidance on the
development of evaluation activities to help
programs identify required staff time and
resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
16
u
u
u
u
u
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping and
Using a Logic Model (wwwcdcgovDHDSP
state_programevaluation_guideslogic_model
htm) a document providing guidance on
the development and use of logic models as
planning and evaluation tools
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashWriting SMART
Objectives (wwwcdcgovDHDSPstate_
programevaluation_guidessmart_objectives
htm) a document providing guidance to
states on the development of realistic and
measurable objectives
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit (wwwcdcgov
dhdsplibrarytoolkitindexhtm) a document
that provides information materials and
tools that state programs can reference and
distribute to businesses primarily through
employer and professional organizations
Heart Disease and Stroke Interactive Maps
(wwwcdcgovdhdsplibrarymapsstatemaps
htm) which present heart disease and stroke
mortality rates by county for the state racial
ethnic group and gender of the userrsquos choice
A Communication Guide for Policy and
Environmental Change (wwwcdcgovdhdsp
libraryheart_stroke_guideindexhtm) which
includes information references and examples
of communication from state programs and
Stroke Addendum to the Communication
Guide (wwwcdcgovdhdsplibraryheart_
stroke_guideindexhtm)
For additional information please visit the CDC
website at wwwcdcgovdhdsp or contact the
Division for Heart Disease and Stroke Prevention
Program Development and Services Branch at
(770) 488-2424
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
17
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
State Heart Disease and Stroke Prevention Program Funding Opportunity Announcement DP07-704 At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
18
Introduction The Funding Opportunity Announcement
(FOA) DP07-704 At-A-Glance provides important
information to assist programs funded under this
announcement to deliver their program as intended
The At-A-Glance highlights aspects of FOA DP07-704
important for all funded programs including
the following
bull Overview of the National Heart Disease and
Stroke Prevention Program
bull Heart Disease and Stroke Prevention State
Program roles
bull Performance measures for Capacity Building Basic
Implementation Optional Funding for Capacity
Building programs and Stroke Networks
bull Funded program reporting requirements
bull Budgetfunding guidance
bull National and administrative policy requirements
If a program needs a copy of the full document
it should contact its project officer (see Program
Contacts section of the full National Heart Disease
and Stroke Prevention Program Staff Orientation
Manual) to fulfill that request
Section 1 Background In 1998 the US Congress provided funding for
CDC to initiate a national state-based cardiovascular
health program The Senate Appropriations
Committee in 2005 encouraged CDC to create the
Division for Heart Disease and Stroke Prevention and
increased resources enabling CDC to reach 32 of the
50 states and the District of Columbia with funding
for heart disease and stroke prevention As of 2008
the Heart Disease and Stroke Prevention (HDSP)
program funds 41 states and the District of Columbia
As the Division for Heart Disease and Stroke
Prevention developed so did the focus of the State
HDSP Program Focusing on the six program priority
areas (noted below) should impact morbidity and
mortality of these diseases State programs should
increase heart disease and stroke prevention policies
and systems change with the potential to impact
the general population and Priority Populations
(see Prevention Works CDC Strategies for a Heart-
healthy and Stroke-free America wwwCDCgov
dhdsplibrary) For more information on the CDC
State HDSP Program visit wwwcdcgovdhdspState_
programindexhtm
A Public Health Action Plan to Prevent Heart Disease
and Stroke (see wwwCDCgovdhdsplibrary)
documents the multiple intervention opportunities
for preventing heart disease and stroke It is
important to work with partners collaboratively in
leveraging resources to address the multiple risk
factors that are associated with these diseases
Announcement DP07-704 supports program
components considered essential to enhancing
the leadership of state health departments in
heart disease and stroke prevention It provides
for the funding of capacity building and basic
implementation programs as well as projects such as
the Optional Funding for Capacity Building Programs
and Stroke Networks
A capacity building program develops the foundation
for a comprehensive cardiovascular disease prevention
program through such activities as partnership
development definition of the burden and
development of a state plan A basic implementation
program enhances capacity building activities and
implements disseminates and evaluates intervention
activities that address the state plan objectives and the
CDC program priority areas 1ndash6
1 Increase control of high blood pressure primarily
in adults and older adults
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
19
2 Increase control of high blood cholesterol
primarily in adults and older adults
3 Increase knowledge of signs and symptoms for
heart attack and stroke and the importance of
calling 9-1-1
4 Improve emergency response
5 Improve quality of heart disease and stroke care
6 Eliminate disparities in terms of race ethnicity
gender geography or socioeconomic status
Optional Funding for Capacity Building Programs
provides support to programs to implement an
evidence-based or promising practice demonstration
project that addresses the CDC program priority
areas 1ndash6
Stroke Networks support a state health department to
increase stroke prevention activities across a group of
three to six contiguous member states with emphasis
on increasing awareness and implementing priority
policy or systems changes across the states
The State HDSP Program is anchored on the
framework of the Socio-ecological Model which
conceptualized the influences of individual
behaviors family and social relationships community
and environmental effects and societal influences
such as policies on health status In order to
promote significant impact for improving the health
of the population interventions should focus on
implementing policy and systems change strategies
that support heart disease and stroke prevention
Policy change can be addressed through a) public
policy (eg establishing certification for hospital-
based stroke centers) or b) organizational policy
(eg businesses providing health benefits plans
that cover preventive services that include blood
pressure control)
System changes are encouraged in three settings
worksites health care and communities An
example of a systems change is when a health
care setting implements electronic records and
patient care management systems that improve the
quality of health care Interventions within systems
are encouraged at the highest level possiblemdashfor
example activities with business coalitions rather
than individual worksites and with managed care
organizations (MCOs) and state medical associations
rather than individual health care sites or physicians
By working at higher levels to affect systems change
states can impact larger segments of the population
Education and awareness efforts to enhance
public understanding and promote actions related
to cardiovascular diseases and the risk factors of
high blood pressure and high cholesterol signs
and symptoms of heart attack and stroke and the
need to call 9-1-1 are also components of capacity
enhancement
An overarching goal of the State HDSP Program
is to address disparities in heart disease and
stroke and the related risk factors using policy and
systems change strategies Based on disparities
(eg raceethnicity gender geographic geography
socioeconomic status) in mortality access to care
or burden of risk factors the State HDSP Program
should identify Priority Populations and implement
interventions to reach those Priority Populations
No one organization will be able to address the
prevention of heart disease and stroke It will require
many organizations working in collaboration if
progress is to be made in accomplishing the Healthy
People 2010 Objectives Collaboration is defined
by the Wilder Foundation as ldquoa mutually beneficial
and well-defined relationship entered into by two
or more organizations to achieve common goals
The relationship includes a commitment to mutual
relationships and goals a jointly developed structure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
20
and shared responsibility mutual authority and
accountability for success and sharing of resources
and rewardsrdquo Developing and maintaining
strategic partnerships are key to the leveraging of
skills and resources to prevent heart disease and
stroke in a comprehensive way The State HDSP
Program has two major roles related to partners
The first is to convene or facilitate collaboration
to develop and implement a comprehensive state
plan and intervention implementation strategies
that addresses heart disease stroke and related
risk factors The second is to develop strategies to
leverage resources and coordinate interventions
with partners that address the six program
priority areas
A logic model has been developed to describe
the State HDSP Program as intended by the CDC
funding to state health departments (see following
page) The model depicts relationships and actions
(eg links between environment and policy
change and individual-level behavioral change)
that are expected to culminate in reduction in
heart disease and stroke
The CDC and state activities are outlined in terms
of capacity building surveillancemonitoring
and interventions Both CDC and state activities
influence changes that lead to short-term
outcomes such as development of a work plan
and strategies for system-level changes effective
implementation of interventions and action by
target audiences and change agents (those who are
in the position to influence policies and systems
such as hospital administrators and MCO decision
makers) These activities and outcomes result in
changes in policy and environmental supports
which in turn influence behavior changes and
improve health status Ultimately these changes
decrease premature death and disability and
eliminate cardiovascular disparities between
general and Priority Populations
The State HDSP logic model also is a tool to guide
program evaluation By identifying the steps
necessary to reach intended outcomes the logic
model provides guidance in evaluating the short and
intermediate outcomes of the program
State evaluation efforts should relate to the National
HDSP Program logic model or to a logic model that
the state develops that complements the national
model and the required program recipient activities
The logic model can also be seen in the CDC
Evaluation Framework for Heart Disease and Stroke
Prevention State Programs at wwwcdcgovdhdsp
Section 2 National Heart Disease and Stroke Prevention State Program Roles In A Public Health Action Plan to Prevent Heart
Disease and Stroke there are four major goals which
are based on Healthy People 2010
Goal 1 Prevention of risk factors
Goal 2 Detection and treatment of risk factors
Goal 3 Early identification and treatment of heart
attacks and strokes
Goal 4 Prevention of recurrent cardiovascular events
CDC-funded State HDSP Programs have a direct
impact on Goals 2 3 and 4 by addressing HDSP
program priority areas 1ndash6 (see Background section)
HDSP programs have a supportive role with other
state health department programs and partners in
addressing Goal 1 Efforts to address Goal 1 related
to tobacco use diabetes obesity poor nutrition
physical inactivity and schools as a worksite should
be done through a supportive or collaborative role
with the state WISEWOMAN diabetes tobacco
nutrition physical activity or coordinated school
health programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
bull State HDSP Programs are encouraged to
coordinate with other programs in ways that
1 Address Goal 1 (eg State HDSP and Nutrition
Programs identify primary prevention messages
related to cholesterol and salt to be included in Nushy
trition Programs where appropriate State HDSP and
Tobacco Programs collaborate to promote use of
state tobacco quit lines State HDSP Program refers
managed care organizations to materials developed
by the Parks and Recreation Department and
Physical Activity Program on safe places to exercise
National HDSP Program Logic Model
State HDSP and WISEWOMAN Programs collaborate
to create systems for educating health care providers
on guidelines focused on risk factor prevention)
2 Enhance inclusion of key messages in the work
of related programs (eg State HDSP Program
works to implement JNC7 guidelines which
include referral to nutrition counseling the
WISEWOMAN Program incorporates education on
signs and symptoms of heart disease and stroke
into ongoing activities the State HDSP Program
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and system change supports
Level bull State bull Local
Settings bull Community bull Health care bull Worksite
Context bull Priority
Populations bull General
populations
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective intervention
implemented focused on
settings and Priority Populations
Change agents
take action
Activate intended audiences
Capa
city B
uildin
gSu
rveil
lance
Inter
vent
ions
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
21
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Background and Overview
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
2
The Burden of Heart Disease and Stroke Heart disease and stroke the first and third leading
causes of death for men and women are among the
most widespread and costly health problems facing
our nation today An estimated 935000 heart attacks
and 795000 strokes occur each year One in four
deaths is caused by heart disease and someone dies
of a stroke on average every four minutes Heart
disease and stroke also are among the leading causes
of disability in the United States Nearly 4 million
people report disability from these causes
Death rates alone cannot describe the burden of
heart disease and stroke In 2010 the total costs of
cardiovascular diseases which include heart disease
and stroke were estimated to be $444 billion
Treatment of these diseases accounts for about $1
of every $6 spent on health care in this country As
the US population ages the economic impact of
cardiovascular diseases on our nationrsquos health care
system will become even greater
Overall death rates for heart disease and stroke have
decreased in the United States in recent decades
However rates for incidence and death continue
to be high especially among some populations
including members of certain racial and ethnic
groups people with low socioeconomic status and
those living in the southeastern United States For
example the risk of having a first-ever stroke is
nearly two times higher among African Americans
than among whites In addition about 55000 more
women than men have a stroke each year Recent
studies show that the prevalence of heart disease and
the percentage of associated premature deaths are
higher among American Indians and Alaska Natives
than among any other US racial or ethnic group
The news is not all bad however Scientific evidence
confirms that many lives can be saved through
prevention and early detection The prevention of
cardiovascular diseases also results in significant
savings of our nationrsquos limited health care resources
CDCrsquos Division for Heart Disease and Stroke
Prevention (DHDSP) is committed to having a
positive impact on cardiovascular diseases
The Division for Heart Disease and Stroke Prevention CDC has engaged in heart disease and stroke
prevention work since the late 1980s beginning
with the emergence of the Cardiovascular Health
Studies (CVH) Branch in the National Center for
Chronic Disease Prevention and Health Promotion
(NCCDPHP) In 1998 CDC and the National Institutes
of Health were named co-leaders of the Healthy
People 2010 objectives for heart disease and stroke
In that same year Congress funded CDC to establish
the National Heart Disease and Stroke Prevention
Program which helps build state- and local-level
comprehensive heart disease and stroke programs
In 2001 following the death of Senator Paul
Coverdell from a stroke Congress funded CDC to
establish state stroke registries to capture data that
can be used to measure and improve the quality of
acute stroke care
In 2006 CDC established DHDSP as one of 10
stand-alone divisions within NCCDPHP DHDSP
was created by combining the CVH Branch the
WISEWOMAN program and the office of the
Division of Adult and Community Healthrsquos Associate
Director for CVH Policy and Research WISEWOMAN
provides uninsured women aged 40ndash64 with access
to screening referral and lifestyle interventions to
help reduce their risk for heart disease and other
chronic diseases
DHDSPrsquos mission is to be the nationrsquos public health
leader for achieving cardiovascular health for all and
reducing the burden of disparities in heart disease
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
3
and stroke DHDSP staff collaborate with national
public- and private-sector partners to plan direct
and coordinate programs and research that reduce
risk factors disease deaths and disparities associated
with heart disease and stroke
DHDSP provides national leadership in addressing
key issues such as sodium consumption awareness
of signs and symptoms of heart attack and stroke
and access to screening and interventions for
cardiovascular problems The results of DHDSPrsquos
work are often highlighted in the national media
have gained widespread exposure on the Internet
and have been published in professional and peer-
reviewed journals and publications
The National Forum for Heart Disease and Stroke Prevention CDC the American Heart Association and the
Association of State and Territorial Health Officials
led the development of the landmark publication
A Public Health Action Plan to Prevent Heart
Disease and Stroke (Action Plan) The National
Forum for Heart Disease and Stroke Prevention
was convened to review draft recommendations
for the Action Plan in September 2002 and in
2003 it became a major vehicle for implementing
the plan This national coalition now representing
more than 80 organizations provides strategic
guidance on heart disease and stroke prevention
activities through the Action Plan and promotes
collaboration through an annual meeting held in
Washington DC and face-to-face meetings with
each of its seven implementation work groups The
Action Plan provides states organizations and key
stakeholders with a framework for planning public
health strategies to prevent heart disease and stroke
throughout the nation
DHDSP Goals 1 Prevent risk factors for heart disease and stroke
2 Increase detection and treatment of risk factors
for heart disease and stroke
3 Increase early identification and treatment of heart
disease and stroke
4 Decrease recurrences of cardiovascular events
5 Foster a skilled and engaged public health
workforce to address heart disease and stroke
Organization and Staffing
DHDSP Structure
DHDSP consists of the Office of the Director
(OD) and three branches the Applied Research
and Evaluation Branch (AREB) the Epidemiology
and Surveillance Branch (ESB) and the Program
Development and Services Branch (PDSB)
office of the Director OD is responsible for resource management research
coordination communications partnership building
external affairs coordination of policy and legislative
activities and global collaborations OD staff
participate in and manage activities related to
Division partnerships such as CDCrsquos Cardiovascular
Health Collaboration the National Forum and the
Healthy People 2010 Partnership
Program Development and services Branch PDSB promotes evidence-based strategies and
programs to reduce health disparities and prevent
heart disease and stroke throughout the nation It
funds and manages cooperative agreements with
states tribal organizations and partners and provides
technical assistance to staff in the National Heart
Disease and Stroke Prevention Program PDSB
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
DHDSP Organizational Structure
Office of the Director
Deputy Director Administrative Office
Associate Director for Science
Strategic Planning Partnerships and External Relations
Global Health Coordinator
Epidemiology and Surveillance Branch
Program Development and Services Branch
WISEWOMAN Team
Senior Advisor to Division Director
Applied Research and Evaluation Branch
Planning Partnerships and Policy Team
Health Communication and Program Information Team
Statistical Unit
Epidemiology and Surveillance Team
Small Area Analysis Team
Health Services Research and Registries Team
Program Services Team Applied Research and Translation Team
Evaluation and Program Effectiveness Team
4
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
5
provides grantees with comprehensive technical
assistance training and programmatic tools and
guidance for the development implementation
and evaluation of programs Together with related
programs across NCCDPHP PDSB provides
leadership to ensure collaboration that can affect
heart disease and stroke prevention outcomes
epidemiology and surveillance Branch ESB studies patterns and trends in the following areas
as they relate to cardiovascular diseases risk factors
costs health behaviors and outcomes barriers to
patient access to care public awareness geographic
variation and disparity of cardiovascular disease
rates among races and ethnic groups These scientific
findings allow DHDSP and its partners to respond
to emerging health risks and promote public health
practice ESB funds and manages the Paul Coverdell
National Acute Stroke Registry Staff provide technical
assistance and expertise through scientific articles
research findings geographic information system
mapping and promotion of new surveillance
methods and technologies
applied research and evaluation Branch AREB works with states partners and colleagues to
conduct and translate applied research and evaluation
of heart disease and stroke prevention efforts It
evaluates programs policies and interventions to
ensure they are working as planned and producing
the intended results It promotes evidence-based
practice by translating scientific findings into practical
resources and tools for public health practitioners
health care providers and others working to prevent
heart disease and stroke In addition AREB supports
state program activities through technical assistance
guidance resource development and capacity
building for applied research and evaluation
Funded Programs DHDSP funds and supports three national heart
disease and stroke prevention programs The fiscal
year 2010 appropriation was $56 million for heart
disease and stroke prevention programs Funds
are awarded through a competitive process for
the National Heart Disease and Stroke Prevention
Program Paul Coverdell National Acute Stroke
Registry and Sodium Reduction in Communities
Program
National Heart Disease and Stroke Prevention Program
The National Heart Disease and Stroke Prevention
Program provides funding and support to state
health departments to manage heart disease and
stroke prevention programs at the state and local
levels DHDSP shares the latest science and practices
with states to help reduce disease deaths and
health disparities related to heart disease and stroke
especially among those at high risk The program
has grown from funding 8 states in 1998 to funding
41 states and the District of Columbia in the current
funding cycle Twenty-eight states are funded for
capacity building and 14 for basic implementation
CDC-funded state programs promote changes to
policies and systems in health care worksite and
community settings and the elimination of health
disparities by emphasizing the ABCS of heart
disease and stroke prevention Some programs also
work to improve emergency response and quality
of acute care
WISEWOMAN
The Well-Integrated Screening and Evaluation for
WOMen Across the Nation (WISEWOMAN) Program
helps women with little or no health insurance
access services that can help reduce their risk for
heart disease stroke and other chronic diseases
The priority age group is women aged 40ndash64 years
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
6
2010 Funded Programs
2011 Funded Programs
NHDSP Funded States
WISEWOMAN Programs
WA
MT
ID WY
NV
AK
HI
AZ NM
TX
KSCO
OK
SD
ND
AR
IN OH
KY
TN
LA ALMS
FL
GA
NY
ME
OR
UT
CA
NE IA
MO
WI
IL
MN
MI
VAWV
SC
NC
PA NH
DE
VT
MD
NJ
RI
DC
MA
CT
Coverdell Stroke Registry States
Sodium Reduction Communities
Unfunded States
Note WISEWOMAN funds two tribal organizations in Alaska but not the state health department
Congress authorized the program in 1993 as an
expansion of services offered through the National
Breast and Cervical Cancer Early Detection Program
DHDSP funds WISEWOMAN programs in 19 states
and 2 tribal organizations Working in local clinics
and health care settings WISEWOMAN provides
heart disease and stroke risk factor screenings and
offers lifestyle interventions to help women increase
their physical activity improve their diet and engage
in tobacco cessation efforts
Paul Coverdell National Acute Stroke Registry
DHDSP funds states to establish surveillance systems
that measure track and provide data to help improve
the delivery and quality of stroke care among acute
stroke patients In 2001 Congress funded CDC to
establish the Paul Coverdell National Acute Stroke
Registry after US Senator Paul Coverdell of Georgia
suffered a fatal stroke while serving in Congress
The goal of the Coverdell Registry is to ensure that
all stroke patients receive the highest quality acute
stroke care available to reduce untimely deaths
prevent disability and avoid recurrent strokes With
Coverdell Registry data states and their health care
partners identify and analyze gaps in stroke care
systems and plan targeted strategies to address
them In June 2004 CDC funded four state health
departments (Georgia Illinois Massachusetts
and North Carolina) to establish Paul Coverdell
National Acute Stroke Registries In the most recent
Paul Coverdell National Acute Stroke Registry
funding cycle (2007ndash2011) CDC funded state health
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
7
departments in Georgia Massachusetts Michigan
Minnesota Ohio and North Carolina In 2007
CDC The Joint Commissionrsquos Primary Stroke Center
Certification program and the American Heart
AssociationAmerican Stroke Associationrsquos Get With
The Guidelinesreg-Stroke program jointly released a set
of standardized stroke performance measures to be
used by all three programs This effort has reduced
duplication of effort increased collaboration and
encouraged hospitals to participate in the programs
Office of the Director
Mississippi Delta Health Collaborative (Delta Health Initiative)
The Mississippi Delta Health Collaborative (MDHC)
is designed to prevent heart disease stroke and
related chronic diseases Through a new five-year
cooperative agreement this initiative will intensify
collaboration among the Mississippi Department of
Health existing chronic disease programs (eg heart
disease and stroke prevention diabetes tobacco
nutrition physical activity) local health departments
other community health care providers (eg
federally qualified health centers) local communities
and CDC This result will be achieved through
implementation of interventions across Mississippirsquos
18-county Delta Region The program will target
the ldquoABCSrdquo of heart disease and stroke prevention
among priority populations in high burden
underserved rural areas
bull Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
bull Hemoglobin A1c (HbA1c) Monitor and control
blood glucose
bull Blood pressure Prevent and control high blood
pressure
bull Cholesterol Prevent and control high LDL-
cholesterol
bull Smoking Prevent initiation and increase cessation
of smoking and increase the percentage of the
population protected by smoke-free air laws or
regulations
The Mississippi Department of Health will provide
leadership and funding support in the Delta
Region to implement prioritized population-based
interventions policy systems and environmental
change selected as appropriate from a set of
prescribed evidence-based strategies in both the
clinical and community settings
WISEWOMAN
The WISEWOMAN Program began a new five-
year funding cycle June 30 2008 The competitive
application process resulted in 21 programs being
funded This is an increase of six programs from the
previous funding cycle Seventeen WISEWOMAN
programs also receive funding to implement the
National Heart Disease and Stroke Prevention
Program
One major focus of the funding opportunity
announcement (FOA) is development of partnerships
At a minimum funded programs are expected to
partner with their statetribal Breast and Cervical
Cancer Early Detection Program Tobacco Control
Program Heart Disease and Stroke Prevention
ProgramCoalition and other programs that
can affect policies and environments in which
WISEWOMAN participants live work and play
Because the majority of WISEWOMAN funding must
be spent on providing direct services to women
partnerships are extremely important to ensure
participant access to affordable and quality resources
to support heart health
WISEWOMAN evaluation emphasizes program
improvement and is based on the CDC Framework
for Program Evaluation in Public Health CDC has
developed key evaluation questions related to the
programrsquos stated goals and logic model components
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
8
The questions are used in the evaluation of the
WISEWOMAN Program Funded programs are
required to conduct evaluations to assess progress
toward meeting stated work plan objectives and to
share results with others including their providers
partners other stakeholders and CDC Funded
programs contribute to the WISEWOMAN Program
evaluation by providing Minimum Data Elements
data submitting information to CDC that supports
program evaluation activities and participating in
activities such as site visits and case studies
Sodium Reduction in Communities
High sodium consumption is a major contributor
to high blood pressure a leading cause of stroke
coronary heart disease heart attack and heart and
kidney failure in the United States The 2010 Dietary
Guidelines for Americans recommend limiting
sodium to less than 2300 milligrams (mg) per day
Individuals who are 51 and older and those of any
age who are African American or have hypertension
diabetes or chronic kidney disease should limit
intake to 1500 mg of sodium per day These groups
account for about half the US population and the
majority of adults
Studies show that on average US adults consume
more than 3400 mg of sodium per day An estimated
77 percent of sodium comes from processed and
restaurant foods Reducing dietary intake of sodium
to 2300 mg per day could prevent as many as 11
million cases of hypertension in the United States
Further reductions in sodium intake to 1500 mg per
day could prevent more than 16 million cases
Through the three-year Sodium Reduction in
Communities cooperative agreement which began in
September 2010 DHDSP is providing support to six
communities to support policy changes designed to
create healthier food environments The communities
receiving support include California (Shasta County)
Kansas (Shawnee County) Los Angeles County
New York City and New York State (Broome and
Schenectady counties)
Program Development and Services Branch
Funded State Programs
National Heart Disease and Stroke Prevention Program The enhanced reach of the National
Heart Disease and Stroke Prevention Program was
a key accomplishment in 2008 Eight new states
(Connecticut Hawaii Idaho Iowa Maryland New
Jersey North Dakota and West Virginia) were funded
as part of the program bringing the total number of
funded programs to 42
Leadership to Center Integration PDSB has
provided leadership to NCCDPHPrsquos initiative to
increase synergy reach and desired health outcomes
in selected NCCDPHP-funded categorical programs
(National Heart Disease and Stroke Prevention
Diabetes Prevention and Control Tobacco Control
Comprehensive Cancer Control Nutrition Physical
Activity and Obesity and the Behavioral Risk Factor
Surveillance System)
National Training DHDSP conducted the 2008
National Heart Disease and Stroke Prevention
Training Institute on September 9ndash11 in Atlanta The
training focused on longer skill-building interactive
workshops that addressed the competencies
program priorities and performance measures of
the FOAs for DHDSPrsquos funded programs It included
the National Heart Disease and Stroke Prevention
Program and WISEWOMAN and was expanded to
include representation from each statersquos heart disease
program as well as American Heart Association
field staff working in the states Informal feedback
indicates that the training has already led to greater
collaboration at the state level
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
9
Management Information System (MIS) In 2008
DHDSP completed revisions for the heart disease
and stroke prevention Web-based MIS The report
generated by the system was changed to a table that
displays an objective time frame status and progress
in an easy-to-read format These changes made the
system more user friendly for states and CDC The
MIS can now be used to
bull Describe state program activities and expected
use of CDC funds
bull Track progress on state program activities and
identify promising practices
bull Assist CDC in identifying the need for training
and technical assistance
bull Standardize the state reporting process to
facilitate evaluation
bull Enable CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Funded Partnerships
Directors of Health Promotion and Education
(DHPE) In 2008 DHDSP continued to support
the DHPECDC Internship Program for Students
of Minority Serving Institutions
National Stroke Association DHDSP assisted with
funding for the Sixth Annual National Public Health
Stroke Summit conducted by the National Stroke
Association in Denver Colorado in December 2007
The Summit brought together 105 state public health
and health care professionals to promote information
sharing knowledge and skill building networking
and partnership development
National Collaborations
Cardiovascular Health (CVH) Council of the National Association of Chronic Disease Directors (NACDD) In 2008 the CVH Council
updated its section of the NACDD website to include
additional materials useful to states and it started
a Web discussion forum that allows states to share
ideas and products The Council obtained private
funds and sponsored the 2-day Northeast Regional
Workshop on Cholesterol Control in which 11
states participated in May 2008 It also funded two
of the participating states (Maine and Maryland)
to do follow-up work on cholesterol control with
their primary care associations and local federally
qualified health centers In March 2008 the
Council led the development of a themed issue of
the e-journal Preventing Chronic Disease In most
cases state program staff coauthored articles with
DHDSP staff The CVH Council worked with DHDSP
to assess the training needs of state programs in
the National Heart Disease and Stroke Prevention
Program and DHDSP used this information to plan
its September 2008 3-day training workshop for state
program and WISEWOMAN staff
Epidemiology and Surveillance Branch
Cardiac Arrest Registry to Enhance Survival
The Cardiac Arrest Registry to Enhance Survival
(CARES) began in 2005 in Atlanta and has since
expanded to 40 communities in 23 states CARES is
a simple but robust registry of cardiac arrest events
that allows participating sites to enter data related
to out-of-hospital cardiac arrest (OHCA) generate
summary reports and compare local data with
similar EMS systems elsewhere Three sources of
data are linked to describe each OHCA event 1)
9-1-1 call center data (to provide incident address
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10
and dispatch and arrival times) 2) EMS data (to
describe initially recorded cardiac rhythm and
treatment methods) and 3) hospital data (emergency
department and hospital outcome hypothermia
treatment and neurologic status at discharge)
Multiple reporting features can be generated and
monitored continuously through secure online access
by CARES participants which allows for longitudinal
internal benchmarking Local EMS administrators
and medical directors are able to identify when and
where cardiac arrests occur which elements of their
EMS system are functioning properly in dealing
with these cases and what changes can be made to
improve outcomes In 2011 CARES began expanding
to statewide participation in six states which will
allow additional communities of different sizes and
population densities to be included in the registry In
addition state-level participation will promote better
communication and collaboration between state and
local EMS providers A recent MMWR Surveillance
Summary was published summarizing CARES data
collected during October 1 2005ndashDecember 31
2010 (wwwcdcgovmmwrpdfssss6008pdf) More
information about CARES can be found on the
CARES website at httpsmycaresnet
Paul Coverdell National Acute Stroke Registry
New Registries The Paul Coverdell National
Acute Stroke Registry program successfully
implemented stroke registries in three newly
funded states in 2007 (Michigan Minnesota and
Ohio) These states made much greater progress
in their first year toward developing program
infrastructure collecting data and engaging in
quality improvement activities than had the four
states that completed their first year of Coverdell
Registry funding in 2004 Much of this progress can
be attributed to CDCrsquos increased capacity to provide
proactive technical assistance to states through
conference calls work groups and resource
materials such as the program resource manual
Supplemental Projects The Coverdell Registry
team developed and funded a supplemental
cooperative agreement to pilot the expansion of
the Coverdell Registry model to other domains
within stroke systems of care North Carolina was
funded to demonstrate the feasibility of linking
pre-hospital EMS data for stroke with the state
Coverdell Registry (the North Carolina Stroke
Care Collaborative) In 2010 in partnership with
the Association of State and Territorial Health
Officials CDC funded two Coverdell states to
develop comprehensive statewide stroke care
systems plans CDC is currently funding the Ohio
Coverdell Registry to study 30-day outcomes
of stroke patients based on the quality of care
provided In partnership with the Agency for
Healthcare Research and Quality CDC has funded
an evidence-based review of transitions in care
from hospital to home or rehabilitation for stroke
patients
National Evaluation Plan Through a yearlong
collaboration with RTI International the Coverdell
Registry developed a national evaluation plan The
plan provides a systematic method of assessing
the annual and long-term performance of the
program including strategic goals and objectives
performance goals performance measures and
targets for program outcomes
Consensus Stroke Performance Measures
Endorsement of the Consensus Stroke
Performance Measures The Coverdell Registry
partnered with the American Heart Association
and The Joint Commission to develop performance
measures for acute stroke care commonly
referred to as the Consensus Stroke Performance
Measures These measures were released to
hospitals throughout the United States in fall
2007 In January 2008 more than 1200 hospitals
began using these measures to improve the quality
of care for acute stroke patients The measures
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11
were submitted to the National Quality Forum in
March 2008 and 8 of the 10 were adopted This
endorsement of the Consensus Stroke Performance
Measures has paved the way for adoption of
these measures by the Centers for Medicare
and Medicaid Services for quality reporting and
meaningful use
Quarterly Data Reports With the implementation
of the Consensus Stroke Performance Measures in
January 2008 CDC began providing states with
quarterly data reports on the measures These
reports provide each state with a summary of its
data on ischemic stroke hemorrhagic stroke and
transient ischemic attacks as well as aggregate data
for all states in the Coverdell Registry program
Applied Research and Evaluation Branch
Building an Economic Evaluation Research Agenda
Based on program needs and research gaps in heart
disease and stroke prevention the Applied Research
and Evaluation Branch developed an agenda to
guide economic research on 1) economic burden
of cardiovascular diseases and cost-effectiveness of
their control 2) economic value of DHDSP-funded
and other state prevention programs 3) CDCrsquos
Internet-based clearinghouse for information on
the economics of cardiovascular diseases and 4)
developing partnerships in economic research to
increase the impact of such research
Stroke Awareness Signs and Symptoms Awareness Campaigns
To provide guidance for state programs a review of
current research on stroke awareness campaigns was
undertaken to identify evidence to support the most
appropriate ways to increase knowledge of signs and
symptoms for stroke the importance of calling 9-1-1
and relationships between the educational campaigns
and outcomes related to awareness of stroke signs
and symptoms
The literature review and synthesis of current
research on stroke awareness campaigns resulted
in the following dissemination activities
bull Development of a fact sheet for state programs on
literature review findings and considerations for
statesrsquo current activities related to stroke awareness
messages including direct education and tools
available to facilitate campaign development
bull Poster presentation at the 2008 National
Conference on Health Communication Marketing
and Media on evaluation guidance for stroke
awareness campaigns The presentation outlined
specific information for states and communities on
how to strengthen the effectiveness and outcome
evaluation of their stroke awareness campaigns
bull Presentation at the 2008 National Heart Disease
and Stroke Prevention Training Institute about
evidence and research on communication and
media campaigns impact considerations of cost
opportunities for partnering and evaluating
results
Comprehensive and Core Indicators
DHDSP released a set of core indicators for
hypertension as part of a comprehensive evidence-
based set of indicators to guide state heart disease
and stroke prevention programs in evaluating their
efforts State health departments received related
key guidance documents training at the National
Heart Disease and Stroke Prevention Training
Institute and a series of follow-up trainings
Indicators are presented in a Consumer Reports
format and rated on multiple dimensions such as
strength of scientific evidence feasibility of data
collection and face validity
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
12
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkitmdash Evaluation Results
CDC worked with the American Institutes for
Research (AIR) to conduct an evaluation of the
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit State health departments
(SHDs) were trained to use the toolkit to promote
state employer-based initiatives on workplace efforts
for heart disease and stroke prevention
From 2005 to 2007 all the SHDs received copies of
the toolkit and were invited to attend training sessions
(one seminar five webinars and three consultations)
To evaluate the usefulness of the toolkit materials
and obtain recommendations two focus groups with
business leaders and Web-based surveys of the SHDs
were conducted In 2006 all 50 states and the District
of Columbia completed the baseline and in 2008 40
states completed the follow-up
Of the 40 SHDs that completed both waves of the
survey the proportion that reported engaging in
employer-based initiatives significantly increased
from 65 percent to 725 percent during the period
examined despite a reported reduction in staff and
limited appropriations About 90 percent of the
SHDs that responded to the 2008 survey are now
working with employers to promote comprehensive
heart disease and stroke prevention programs
disseminate best practices establish employer-
oriented partnerships participate in seminars for
employers and provide business leaders with
resources Partnerships with employer groups or
business coalitions have focused on worksite policy
changes health promotion and education and
worksite surveillance and assessments In parallel
to these experiences the SHDs have increased their
overall level of confidence in their knowledge and
skills Most of the SHDs (61 percent) agreed that
the CDC trainings and consultations helped them
improve their heart disease and stroke prevention
programs and use the toolkit more effectively
Participation in the trainings was positively associated
with engagement in worksite health promotion and
education The SHDs that received federal funding
had significantly higher participation in macro-
marketing activities reaching employers through
business coalitions associations task forces and
champions and were more likely to establish
partnerships with employer groups and government
agencies
The Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit is available at wwwcdc
govdhdsplibrarytoolkitindexhtm
The Branch also provides economics support to
the Division and partners by documenting costs of
cardiovascular diseases and their risk factors and
identifying cost-effective interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
13
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
National Heart Disease and Stroke Prevention Program Overview
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
14
u Blood pressure Prevent and control high blood Program Overview pressure reduce sodium intake
bull In 1998 the US Congress provided funding
for CDC to initiate a national state-based Heart
Disease and Stroke Prevention (HDSP) program in
eight states
bull CDC funds programs in 41 states and the
District of Columbia Twenty-eight are capacity
building (planning) programs and 14 are basic
implementation (intervention) programs
bull Capacity Building Programs Alabama
Alaska Arizona California Colorado Connecticut
District of Columbia Hawaii Idaho Illinois Iowa
Kansas Kentucky Louisiana Maryland Michigan
Minnesota Mississippi Nebraska New Jersey
North Dakota Ohio Oklahoma Oregon Rhode
Island Tennessee Texas and Wisconsin
bull Basic Implementation Programs Arkansas
Florida Georgia Maine Massachusetts Missouri
Montana New York North Carolina South
Carolina Utah Virginia Washington and West
Virginia
National Heart Disease and Stroke Prevention Program Goals bull Enhance state capacity to plan implement track
and sustain population-based interventions to
address heart disease stroke and related risk
factors Focus program efforts on population-
based policy and systems change strategies to
impact the ldquoABCSrdquo of heart disease and stroke
prevention
u Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
u Cholesterol Prevent and control high
cholesterol
u Smoking Increase the number of smokers
counseled to quit and referred to quitlines by
health care workers increase availability of no
or low-cost cessation products and collaborate
with efforts to increase the percentage of the
population protected by smoke-free air laws
and regulations
To a lesser extent state HDSP programs work to
improve emergency response and quality of acute
care systems
State HDSP programs work to eliminate health
disparities in priority populations (ie groups with
increased burden or need based on race ethnicity
gender geography or socioeconomic status) as an
overarching principle
bull Collaborate with chronic disease programs (eg
those focusing on tobacco diabetes physical
inactivity poor nutrition and obesityoverweight)
and partners to develop and integrate population-
based strategies to prevent heart disease and
stroke
bull Promote cardiovascular health in health care
worksite and community settings through policy
and systems changes
bull Identify and evaluate promising practices to
address heart disease and stroke
bull Conduct surveillance of heart disease stroke
and related risk factors
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
15
u
u
Key Responsibilities of State Capacity Building Programs bull Facilitate collaboration with public- and private-
sector partners such as not-for-profit health
agencies health systems organizations emergency
response agencies federally funded health centers
businesses priority population organizations and
voluntary health organizations
bull Document the state burden of heart disease
stroke and related risk factors
bull Develop plans for population-based strategies
for preventing heart disease and stroke among
general and Priority Populations
bull Develop a comprehensive state HDSP plan
bull Develop an HDSP program logic model and
evaluation plan
bull Assess assets and gaps in state policy and systems
related to HDSP in health care worksite and
community settings
Key Responsibilities of State Basic Implementation Programs bull Enhance all capacity-building program activities
bull Implement and evaluate policy systems change
and educational interventions that address the
six HDSP program priority areas in health care
worksite and community settings
bull Provide training and technical assistance to
public health and health care professionals and
partners to support policy and system changes
that will encourage heart disease and stroke
prevention
How CDC Assists State Heart Disease and Stroke Prevention Programs bull Provides training technical assistance and
funding
bull Funds applied research on heart disease and
stroke interventions and elimination of disparities
that is relevant to state programs
bull Identifies and disseminates science-based
promising practices
bull Partners with national organizations to help states
address prevention of heart disease and stroke
bull Facilitates collaborations with other state chronic
disease programs or activities that address risk
factors populations or settings related to heart
disease and stroke prevention and program
priority areas
bull Develops and disseminates publications and tools
such as
u CDCynergy a CD-ROM-based tool for
planning health communication interventions
State Heart Disease and Stroke Prevention
Program Evaluation Framework (wwwcdc
govdhdsplibraryevaluation_framework
indexhtm) a document providing guidance
on systematic ways to measure the success of
public health programs and on logic model
development
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping an
Evaluation Plan (wwwcdcgovDHDSPstate_
programevaluation_guidesevaluation_plan
htm) a document providing guidance on the
development of evaluation activities to help
programs identify required staff time and
resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
16
u
u
u
u
u
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping and
Using a Logic Model (wwwcdcgovDHDSP
state_programevaluation_guideslogic_model
htm) a document providing guidance on
the development and use of logic models as
planning and evaluation tools
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashWriting SMART
Objectives (wwwcdcgovDHDSPstate_
programevaluation_guidessmart_objectives
htm) a document providing guidance to
states on the development of realistic and
measurable objectives
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit (wwwcdcgov
dhdsplibrarytoolkitindexhtm) a document
that provides information materials and
tools that state programs can reference and
distribute to businesses primarily through
employer and professional organizations
Heart Disease and Stroke Interactive Maps
(wwwcdcgovdhdsplibrarymapsstatemaps
htm) which present heart disease and stroke
mortality rates by county for the state racial
ethnic group and gender of the userrsquos choice
A Communication Guide for Policy and
Environmental Change (wwwcdcgovdhdsp
libraryheart_stroke_guideindexhtm) which
includes information references and examples
of communication from state programs and
Stroke Addendum to the Communication
Guide (wwwcdcgovdhdsplibraryheart_
stroke_guideindexhtm)
For additional information please visit the CDC
website at wwwcdcgovdhdsp or contact the
Division for Heart Disease and Stroke Prevention
Program Development and Services Branch at
(770) 488-2424
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
17
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
State Heart Disease and Stroke Prevention Program Funding Opportunity Announcement DP07-704 At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
18
Introduction The Funding Opportunity Announcement
(FOA) DP07-704 At-A-Glance provides important
information to assist programs funded under this
announcement to deliver their program as intended
The At-A-Glance highlights aspects of FOA DP07-704
important for all funded programs including
the following
bull Overview of the National Heart Disease and
Stroke Prevention Program
bull Heart Disease and Stroke Prevention State
Program roles
bull Performance measures for Capacity Building Basic
Implementation Optional Funding for Capacity
Building programs and Stroke Networks
bull Funded program reporting requirements
bull Budgetfunding guidance
bull National and administrative policy requirements
If a program needs a copy of the full document
it should contact its project officer (see Program
Contacts section of the full National Heart Disease
and Stroke Prevention Program Staff Orientation
Manual) to fulfill that request
Section 1 Background In 1998 the US Congress provided funding for
CDC to initiate a national state-based cardiovascular
health program The Senate Appropriations
Committee in 2005 encouraged CDC to create the
Division for Heart Disease and Stroke Prevention and
increased resources enabling CDC to reach 32 of the
50 states and the District of Columbia with funding
for heart disease and stroke prevention As of 2008
the Heart Disease and Stroke Prevention (HDSP)
program funds 41 states and the District of Columbia
As the Division for Heart Disease and Stroke
Prevention developed so did the focus of the State
HDSP Program Focusing on the six program priority
areas (noted below) should impact morbidity and
mortality of these diseases State programs should
increase heart disease and stroke prevention policies
and systems change with the potential to impact
the general population and Priority Populations
(see Prevention Works CDC Strategies for a Heart-
healthy and Stroke-free America wwwCDCgov
dhdsplibrary) For more information on the CDC
State HDSP Program visit wwwcdcgovdhdspState_
programindexhtm
A Public Health Action Plan to Prevent Heart Disease
and Stroke (see wwwCDCgovdhdsplibrary)
documents the multiple intervention opportunities
for preventing heart disease and stroke It is
important to work with partners collaboratively in
leveraging resources to address the multiple risk
factors that are associated with these diseases
Announcement DP07-704 supports program
components considered essential to enhancing
the leadership of state health departments in
heart disease and stroke prevention It provides
for the funding of capacity building and basic
implementation programs as well as projects such as
the Optional Funding for Capacity Building Programs
and Stroke Networks
A capacity building program develops the foundation
for a comprehensive cardiovascular disease prevention
program through such activities as partnership
development definition of the burden and
development of a state plan A basic implementation
program enhances capacity building activities and
implements disseminates and evaluates intervention
activities that address the state plan objectives and the
CDC program priority areas 1ndash6
1 Increase control of high blood pressure primarily
in adults and older adults
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19
2 Increase control of high blood cholesterol
primarily in adults and older adults
3 Increase knowledge of signs and symptoms for
heart attack and stroke and the importance of
calling 9-1-1
4 Improve emergency response
5 Improve quality of heart disease and stroke care
6 Eliminate disparities in terms of race ethnicity
gender geography or socioeconomic status
Optional Funding for Capacity Building Programs
provides support to programs to implement an
evidence-based or promising practice demonstration
project that addresses the CDC program priority
areas 1ndash6
Stroke Networks support a state health department to
increase stroke prevention activities across a group of
three to six contiguous member states with emphasis
on increasing awareness and implementing priority
policy or systems changes across the states
The State HDSP Program is anchored on the
framework of the Socio-ecological Model which
conceptualized the influences of individual
behaviors family and social relationships community
and environmental effects and societal influences
such as policies on health status In order to
promote significant impact for improving the health
of the population interventions should focus on
implementing policy and systems change strategies
that support heart disease and stroke prevention
Policy change can be addressed through a) public
policy (eg establishing certification for hospital-
based stroke centers) or b) organizational policy
(eg businesses providing health benefits plans
that cover preventive services that include blood
pressure control)
System changes are encouraged in three settings
worksites health care and communities An
example of a systems change is when a health
care setting implements electronic records and
patient care management systems that improve the
quality of health care Interventions within systems
are encouraged at the highest level possiblemdashfor
example activities with business coalitions rather
than individual worksites and with managed care
organizations (MCOs) and state medical associations
rather than individual health care sites or physicians
By working at higher levels to affect systems change
states can impact larger segments of the population
Education and awareness efforts to enhance
public understanding and promote actions related
to cardiovascular diseases and the risk factors of
high blood pressure and high cholesterol signs
and symptoms of heart attack and stroke and the
need to call 9-1-1 are also components of capacity
enhancement
An overarching goal of the State HDSP Program
is to address disparities in heart disease and
stroke and the related risk factors using policy and
systems change strategies Based on disparities
(eg raceethnicity gender geographic geography
socioeconomic status) in mortality access to care
or burden of risk factors the State HDSP Program
should identify Priority Populations and implement
interventions to reach those Priority Populations
No one organization will be able to address the
prevention of heart disease and stroke It will require
many organizations working in collaboration if
progress is to be made in accomplishing the Healthy
People 2010 Objectives Collaboration is defined
by the Wilder Foundation as ldquoa mutually beneficial
and well-defined relationship entered into by two
or more organizations to achieve common goals
The relationship includes a commitment to mutual
relationships and goals a jointly developed structure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
20
and shared responsibility mutual authority and
accountability for success and sharing of resources
and rewardsrdquo Developing and maintaining
strategic partnerships are key to the leveraging of
skills and resources to prevent heart disease and
stroke in a comprehensive way The State HDSP
Program has two major roles related to partners
The first is to convene or facilitate collaboration
to develop and implement a comprehensive state
plan and intervention implementation strategies
that addresses heart disease stroke and related
risk factors The second is to develop strategies to
leverage resources and coordinate interventions
with partners that address the six program
priority areas
A logic model has been developed to describe
the State HDSP Program as intended by the CDC
funding to state health departments (see following
page) The model depicts relationships and actions
(eg links between environment and policy
change and individual-level behavioral change)
that are expected to culminate in reduction in
heart disease and stroke
The CDC and state activities are outlined in terms
of capacity building surveillancemonitoring
and interventions Both CDC and state activities
influence changes that lead to short-term
outcomes such as development of a work plan
and strategies for system-level changes effective
implementation of interventions and action by
target audiences and change agents (those who are
in the position to influence policies and systems
such as hospital administrators and MCO decision
makers) These activities and outcomes result in
changes in policy and environmental supports
which in turn influence behavior changes and
improve health status Ultimately these changes
decrease premature death and disability and
eliminate cardiovascular disparities between
general and Priority Populations
The State HDSP logic model also is a tool to guide
program evaluation By identifying the steps
necessary to reach intended outcomes the logic
model provides guidance in evaluating the short and
intermediate outcomes of the program
State evaluation efforts should relate to the National
HDSP Program logic model or to a logic model that
the state develops that complements the national
model and the required program recipient activities
The logic model can also be seen in the CDC
Evaluation Framework for Heart Disease and Stroke
Prevention State Programs at wwwcdcgovdhdsp
Section 2 National Heart Disease and Stroke Prevention State Program Roles In A Public Health Action Plan to Prevent Heart
Disease and Stroke there are four major goals which
are based on Healthy People 2010
Goal 1 Prevention of risk factors
Goal 2 Detection and treatment of risk factors
Goal 3 Early identification and treatment of heart
attacks and strokes
Goal 4 Prevention of recurrent cardiovascular events
CDC-funded State HDSP Programs have a direct
impact on Goals 2 3 and 4 by addressing HDSP
program priority areas 1ndash6 (see Background section)
HDSP programs have a supportive role with other
state health department programs and partners in
addressing Goal 1 Efforts to address Goal 1 related
to tobacco use diabetes obesity poor nutrition
physical inactivity and schools as a worksite should
be done through a supportive or collaborative role
with the state WISEWOMAN diabetes tobacco
nutrition physical activity or coordinated school
health programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
bull State HDSP Programs are encouraged to
coordinate with other programs in ways that
1 Address Goal 1 (eg State HDSP and Nutrition
Programs identify primary prevention messages
related to cholesterol and salt to be included in Nushy
trition Programs where appropriate State HDSP and
Tobacco Programs collaborate to promote use of
state tobacco quit lines State HDSP Program refers
managed care organizations to materials developed
by the Parks and Recreation Department and
Physical Activity Program on safe places to exercise
National HDSP Program Logic Model
State HDSP and WISEWOMAN Programs collaborate
to create systems for educating health care providers
on guidelines focused on risk factor prevention)
2 Enhance inclusion of key messages in the work
of related programs (eg State HDSP Program
works to implement JNC7 guidelines which
include referral to nutrition counseling the
WISEWOMAN Program incorporates education on
signs and symptoms of heart disease and stroke
into ongoing activities the State HDSP Program
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and system change supports
Level bull State bull Local
Settings bull Community bull Health care bull Worksite
Context bull Priority
Populations bull General
populations
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective intervention
implemented focused on
settings and Priority Populations
Change agents
take action
Activate intended audiences
Capa
city B
uildin
gSu
rveil
lance
Inter
vent
ions
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
21
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
2
The Burden of Heart Disease and Stroke Heart disease and stroke the first and third leading
causes of death for men and women are among the
most widespread and costly health problems facing
our nation today An estimated 935000 heart attacks
and 795000 strokes occur each year One in four
deaths is caused by heart disease and someone dies
of a stroke on average every four minutes Heart
disease and stroke also are among the leading causes
of disability in the United States Nearly 4 million
people report disability from these causes
Death rates alone cannot describe the burden of
heart disease and stroke In 2010 the total costs of
cardiovascular diseases which include heart disease
and stroke were estimated to be $444 billion
Treatment of these diseases accounts for about $1
of every $6 spent on health care in this country As
the US population ages the economic impact of
cardiovascular diseases on our nationrsquos health care
system will become even greater
Overall death rates for heart disease and stroke have
decreased in the United States in recent decades
However rates for incidence and death continue
to be high especially among some populations
including members of certain racial and ethnic
groups people with low socioeconomic status and
those living in the southeastern United States For
example the risk of having a first-ever stroke is
nearly two times higher among African Americans
than among whites In addition about 55000 more
women than men have a stroke each year Recent
studies show that the prevalence of heart disease and
the percentage of associated premature deaths are
higher among American Indians and Alaska Natives
than among any other US racial or ethnic group
The news is not all bad however Scientific evidence
confirms that many lives can be saved through
prevention and early detection The prevention of
cardiovascular diseases also results in significant
savings of our nationrsquos limited health care resources
CDCrsquos Division for Heart Disease and Stroke
Prevention (DHDSP) is committed to having a
positive impact on cardiovascular diseases
The Division for Heart Disease and Stroke Prevention CDC has engaged in heart disease and stroke
prevention work since the late 1980s beginning
with the emergence of the Cardiovascular Health
Studies (CVH) Branch in the National Center for
Chronic Disease Prevention and Health Promotion
(NCCDPHP) In 1998 CDC and the National Institutes
of Health were named co-leaders of the Healthy
People 2010 objectives for heart disease and stroke
In that same year Congress funded CDC to establish
the National Heart Disease and Stroke Prevention
Program which helps build state- and local-level
comprehensive heart disease and stroke programs
In 2001 following the death of Senator Paul
Coverdell from a stroke Congress funded CDC to
establish state stroke registries to capture data that
can be used to measure and improve the quality of
acute stroke care
In 2006 CDC established DHDSP as one of 10
stand-alone divisions within NCCDPHP DHDSP
was created by combining the CVH Branch the
WISEWOMAN program and the office of the
Division of Adult and Community Healthrsquos Associate
Director for CVH Policy and Research WISEWOMAN
provides uninsured women aged 40ndash64 with access
to screening referral and lifestyle interventions to
help reduce their risk for heart disease and other
chronic diseases
DHDSPrsquos mission is to be the nationrsquos public health
leader for achieving cardiovascular health for all and
reducing the burden of disparities in heart disease
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
3
and stroke DHDSP staff collaborate with national
public- and private-sector partners to plan direct
and coordinate programs and research that reduce
risk factors disease deaths and disparities associated
with heart disease and stroke
DHDSP provides national leadership in addressing
key issues such as sodium consumption awareness
of signs and symptoms of heart attack and stroke
and access to screening and interventions for
cardiovascular problems The results of DHDSPrsquos
work are often highlighted in the national media
have gained widespread exposure on the Internet
and have been published in professional and peer-
reviewed journals and publications
The National Forum for Heart Disease and Stroke Prevention CDC the American Heart Association and the
Association of State and Territorial Health Officials
led the development of the landmark publication
A Public Health Action Plan to Prevent Heart
Disease and Stroke (Action Plan) The National
Forum for Heart Disease and Stroke Prevention
was convened to review draft recommendations
for the Action Plan in September 2002 and in
2003 it became a major vehicle for implementing
the plan This national coalition now representing
more than 80 organizations provides strategic
guidance on heart disease and stroke prevention
activities through the Action Plan and promotes
collaboration through an annual meeting held in
Washington DC and face-to-face meetings with
each of its seven implementation work groups The
Action Plan provides states organizations and key
stakeholders with a framework for planning public
health strategies to prevent heart disease and stroke
throughout the nation
DHDSP Goals 1 Prevent risk factors for heart disease and stroke
2 Increase detection and treatment of risk factors
for heart disease and stroke
3 Increase early identification and treatment of heart
disease and stroke
4 Decrease recurrences of cardiovascular events
5 Foster a skilled and engaged public health
workforce to address heart disease and stroke
Organization and Staffing
DHDSP Structure
DHDSP consists of the Office of the Director
(OD) and three branches the Applied Research
and Evaluation Branch (AREB) the Epidemiology
and Surveillance Branch (ESB) and the Program
Development and Services Branch (PDSB)
office of the Director OD is responsible for resource management research
coordination communications partnership building
external affairs coordination of policy and legislative
activities and global collaborations OD staff
participate in and manage activities related to
Division partnerships such as CDCrsquos Cardiovascular
Health Collaboration the National Forum and the
Healthy People 2010 Partnership
Program Development and services Branch PDSB promotes evidence-based strategies and
programs to reduce health disparities and prevent
heart disease and stroke throughout the nation It
funds and manages cooperative agreements with
states tribal organizations and partners and provides
technical assistance to staff in the National Heart
Disease and Stroke Prevention Program PDSB
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
DHDSP Organizational Structure
Office of the Director
Deputy Director Administrative Office
Associate Director for Science
Strategic Planning Partnerships and External Relations
Global Health Coordinator
Epidemiology and Surveillance Branch
Program Development and Services Branch
WISEWOMAN Team
Senior Advisor to Division Director
Applied Research and Evaluation Branch
Planning Partnerships and Policy Team
Health Communication and Program Information Team
Statistical Unit
Epidemiology and Surveillance Team
Small Area Analysis Team
Health Services Research and Registries Team
Program Services Team Applied Research and Translation Team
Evaluation and Program Effectiveness Team
4
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5
provides grantees with comprehensive technical
assistance training and programmatic tools and
guidance for the development implementation
and evaluation of programs Together with related
programs across NCCDPHP PDSB provides
leadership to ensure collaboration that can affect
heart disease and stroke prevention outcomes
epidemiology and surveillance Branch ESB studies patterns and trends in the following areas
as they relate to cardiovascular diseases risk factors
costs health behaviors and outcomes barriers to
patient access to care public awareness geographic
variation and disparity of cardiovascular disease
rates among races and ethnic groups These scientific
findings allow DHDSP and its partners to respond
to emerging health risks and promote public health
practice ESB funds and manages the Paul Coverdell
National Acute Stroke Registry Staff provide technical
assistance and expertise through scientific articles
research findings geographic information system
mapping and promotion of new surveillance
methods and technologies
applied research and evaluation Branch AREB works with states partners and colleagues to
conduct and translate applied research and evaluation
of heart disease and stroke prevention efforts It
evaluates programs policies and interventions to
ensure they are working as planned and producing
the intended results It promotes evidence-based
practice by translating scientific findings into practical
resources and tools for public health practitioners
health care providers and others working to prevent
heart disease and stroke In addition AREB supports
state program activities through technical assistance
guidance resource development and capacity
building for applied research and evaluation
Funded Programs DHDSP funds and supports three national heart
disease and stroke prevention programs The fiscal
year 2010 appropriation was $56 million for heart
disease and stroke prevention programs Funds
are awarded through a competitive process for
the National Heart Disease and Stroke Prevention
Program Paul Coverdell National Acute Stroke
Registry and Sodium Reduction in Communities
Program
National Heart Disease and Stroke Prevention Program
The National Heart Disease and Stroke Prevention
Program provides funding and support to state
health departments to manage heart disease and
stroke prevention programs at the state and local
levels DHDSP shares the latest science and practices
with states to help reduce disease deaths and
health disparities related to heart disease and stroke
especially among those at high risk The program
has grown from funding 8 states in 1998 to funding
41 states and the District of Columbia in the current
funding cycle Twenty-eight states are funded for
capacity building and 14 for basic implementation
CDC-funded state programs promote changes to
policies and systems in health care worksite and
community settings and the elimination of health
disparities by emphasizing the ABCS of heart
disease and stroke prevention Some programs also
work to improve emergency response and quality
of acute care
WISEWOMAN
The Well-Integrated Screening and Evaluation for
WOMen Across the Nation (WISEWOMAN) Program
helps women with little or no health insurance
access services that can help reduce their risk for
heart disease stroke and other chronic diseases
The priority age group is women aged 40ndash64 years
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
6
2010 Funded Programs
2011 Funded Programs
NHDSP Funded States
WISEWOMAN Programs
WA
MT
ID WY
NV
AK
HI
AZ NM
TX
KSCO
OK
SD
ND
AR
IN OH
KY
TN
LA ALMS
FL
GA
NY
ME
OR
UT
CA
NE IA
MO
WI
IL
MN
MI
VAWV
SC
NC
PA NH
DE
VT
MD
NJ
RI
DC
MA
CT
Coverdell Stroke Registry States
Sodium Reduction Communities
Unfunded States
Note WISEWOMAN funds two tribal organizations in Alaska but not the state health department
Congress authorized the program in 1993 as an
expansion of services offered through the National
Breast and Cervical Cancer Early Detection Program
DHDSP funds WISEWOMAN programs in 19 states
and 2 tribal organizations Working in local clinics
and health care settings WISEWOMAN provides
heart disease and stroke risk factor screenings and
offers lifestyle interventions to help women increase
their physical activity improve their diet and engage
in tobacco cessation efforts
Paul Coverdell National Acute Stroke Registry
DHDSP funds states to establish surveillance systems
that measure track and provide data to help improve
the delivery and quality of stroke care among acute
stroke patients In 2001 Congress funded CDC to
establish the Paul Coverdell National Acute Stroke
Registry after US Senator Paul Coverdell of Georgia
suffered a fatal stroke while serving in Congress
The goal of the Coverdell Registry is to ensure that
all stroke patients receive the highest quality acute
stroke care available to reduce untimely deaths
prevent disability and avoid recurrent strokes With
Coverdell Registry data states and their health care
partners identify and analyze gaps in stroke care
systems and plan targeted strategies to address
them In June 2004 CDC funded four state health
departments (Georgia Illinois Massachusetts
and North Carolina) to establish Paul Coverdell
National Acute Stroke Registries In the most recent
Paul Coverdell National Acute Stroke Registry
funding cycle (2007ndash2011) CDC funded state health
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
7
departments in Georgia Massachusetts Michigan
Minnesota Ohio and North Carolina In 2007
CDC The Joint Commissionrsquos Primary Stroke Center
Certification program and the American Heart
AssociationAmerican Stroke Associationrsquos Get With
The Guidelinesreg-Stroke program jointly released a set
of standardized stroke performance measures to be
used by all three programs This effort has reduced
duplication of effort increased collaboration and
encouraged hospitals to participate in the programs
Office of the Director
Mississippi Delta Health Collaborative (Delta Health Initiative)
The Mississippi Delta Health Collaborative (MDHC)
is designed to prevent heart disease stroke and
related chronic diseases Through a new five-year
cooperative agreement this initiative will intensify
collaboration among the Mississippi Department of
Health existing chronic disease programs (eg heart
disease and stroke prevention diabetes tobacco
nutrition physical activity) local health departments
other community health care providers (eg
federally qualified health centers) local communities
and CDC This result will be achieved through
implementation of interventions across Mississippirsquos
18-county Delta Region The program will target
the ldquoABCSrdquo of heart disease and stroke prevention
among priority populations in high burden
underserved rural areas
bull Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
bull Hemoglobin A1c (HbA1c) Monitor and control
blood glucose
bull Blood pressure Prevent and control high blood
pressure
bull Cholesterol Prevent and control high LDL-
cholesterol
bull Smoking Prevent initiation and increase cessation
of smoking and increase the percentage of the
population protected by smoke-free air laws or
regulations
The Mississippi Department of Health will provide
leadership and funding support in the Delta
Region to implement prioritized population-based
interventions policy systems and environmental
change selected as appropriate from a set of
prescribed evidence-based strategies in both the
clinical and community settings
WISEWOMAN
The WISEWOMAN Program began a new five-
year funding cycle June 30 2008 The competitive
application process resulted in 21 programs being
funded This is an increase of six programs from the
previous funding cycle Seventeen WISEWOMAN
programs also receive funding to implement the
National Heart Disease and Stroke Prevention
Program
One major focus of the funding opportunity
announcement (FOA) is development of partnerships
At a minimum funded programs are expected to
partner with their statetribal Breast and Cervical
Cancer Early Detection Program Tobacco Control
Program Heart Disease and Stroke Prevention
ProgramCoalition and other programs that
can affect policies and environments in which
WISEWOMAN participants live work and play
Because the majority of WISEWOMAN funding must
be spent on providing direct services to women
partnerships are extremely important to ensure
participant access to affordable and quality resources
to support heart health
WISEWOMAN evaluation emphasizes program
improvement and is based on the CDC Framework
for Program Evaluation in Public Health CDC has
developed key evaluation questions related to the
programrsquos stated goals and logic model components
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8
The questions are used in the evaluation of the
WISEWOMAN Program Funded programs are
required to conduct evaluations to assess progress
toward meeting stated work plan objectives and to
share results with others including their providers
partners other stakeholders and CDC Funded
programs contribute to the WISEWOMAN Program
evaluation by providing Minimum Data Elements
data submitting information to CDC that supports
program evaluation activities and participating in
activities such as site visits and case studies
Sodium Reduction in Communities
High sodium consumption is a major contributor
to high blood pressure a leading cause of stroke
coronary heart disease heart attack and heart and
kidney failure in the United States The 2010 Dietary
Guidelines for Americans recommend limiting
sodium to less than 2300 milligrams (mg) per day
Individuals who are 51 and older and those of any
age who are African American or have hypertension
diabetes or chronic kidney disease should limit
intake to 1500 mg of sodium per day These groups
account for about half the US population and the
majority of adults
Studies show that on average US adults consume
more than 3400 mg of sodium per day An estimated
77 percent of sodium comes from processed and
restaurant foods Reducing dietary intake of sodium
to 2300 mg per day could prevent as many as 11
million cases of hypertension in the United States
Further reductions in sodium intake to 1500 mg per
day could prevent more than 16 million cases
Through the three-year Sodium Reduction in
Communities cooperative agreement which began in
September 2010 DHDSP is providing support to six
communities to support policy changes designed to
create healthier food environments The communities
receiving support include California (Shasta County)
Kansas (Shawnee County) Los Angeles County
New York City and New York State (Broome and
Schenectady counties)
Program Development and Services Branch
Funded State Programs
National Heart Disease and Stroke Prevention Program The enhanced reach of the National
Heart Disease and Stroke Prevention Program was
a key accomplishment in 2008 Eight new states
(Connecticut Hawaii Idaho Iowa Maryland New
Jersey North Dakota and West Virginia) were funded
as part of the program bringing the total number of
funded programs to 42
Leadership to Center Integration PDSB has
provided leadership to NCCDPHPrsquos initiative to
increase synergy reach and desired health outcomes
in selected NCCDPHP-funded categorical programs
(National Heart Disease and Stroke Prevention
Diabetes Prevention and Control Tobacco Control
Comprehensive Cancer Control Nutrition Physical
Activity and Obesity and the Behavioral Risk Factor
Surveillance System)
National Training DHDSP conducted the 2008
National Heart Disease and Stroke Prevention
Training Institute on September 9ndash11 in Atlanta The
training focused on longer skill-building interactive
workshops that addressed the competencies
program priorities and performance measures of
the FOAs for DHDSPrsquos funded programs It included
the National Heart Disease and Stroke Prevention
Program and WISEWOMAN and was expanded to
include representation from each statersquos heart disease
program as well as American Heart Association
field staff working in the states Informal feedback
indicates that the training has already led to greater
collaboration at the state level
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
9
Management Information System (MIS) In 2008
DHDSP completed revisions for the heart disease
and stroke prevention Web-based MIS The report
generated by the system was changed to a table that
displays an objective time frame status and progress
in an easy-to-read format These changes made the
system more user friendly for states and CDC The
MIS can now be used to
bull Describe state program activities and expected
use of CDC funds
bull Track progress on state program activities and
identify promising practices
bull Assist CDC in identifying the need for training
and technical assistance
bull Standardize the state reporting process to
facilitate evaluation
bull Enable CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Funded Partnerships
Directors of Health Promotion and Education
(DHPE) In 2008 DHDSP continued to support
the DHPECDC Internship Program for Students
of Minority Serving Institutions
National Stroke Association DHDSP assisted with
funding for the Sixth Annual National Public Health
Stroke Summit conducted by the National Stroke
Association in Denver Colorado in December 2007
The Summit brought together 105 state public health
and health care professionals to promote information
sharing knowledge and skill building networking
and partnership development
National Collaborations
Cardiovascular Health (CVH) Council of the National Association of Chronic Disease Directors (NACDD) In 2008 the CVH Council
updated its section of the NACDD website to include
additional materials useful to states and it started
a Web discussion forum that allows states to share
ideas and products The Council obtained private
funds and sponsored the 2-day Northeast Regional
Workshop on Cholesterol Control in which 11
states participated in May 2008 It also funded two
of the participating states (Maine and Maryland)
to do follow-up work on cholesterol control with
their primary care associations and local federally
qualified health centers In March 2008 the
Council led the development of a themed issue of
the e-journal Preventing Chronic Disease In most
cases state program staff coauthored articles with
DHDSP staff The CVH Council worked with DHDSP
to assess the training needs of state programs in
the National Heart Disease and Stroke Prevention
Program and DHDSP used this information to plan
its September 2008 3-day training workshop for state
program and WISEWOMAN staff
Epidemiology and Surveillance Branch
Cardiac Arrest Registry to Enhance Survival
The Cardiac Arrest Registry to Enhance Survival
(CARES) began in 2005 in Atlanta and has since
expanded to 40 communities in 23 states CARES is
a simple but robust registry of cardiac arrest events
that allows participating sites to enter data related
to out-of-hospital cardiac arrest (OHCA) generate
summary reports and compare local data with
similar EMS systems elsewhere Three sources of
data are linked to describe each OHCA event 1)
9-1-1 call center data (to provide incident address
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
10
and dispatch and arrival times) 2) EMS data (to
describe initially recorded cardiac rhythm and
treatment methods) and 3) hospital data (emergency
department and hospital outcome hypothermia
treatment and neurologic status at discharge)
Multiple reporting features can be generated and
monitored continuously through secure online access
by CARES participants which allows for longitudinal
internal benchmarking Local EMS administrators
and medical directors are able to identify when and
where cardiac arrests occur which elements of their
EMS system are functioning properly in dealing
with these cases and what changes can be made to
improve outcomes In 2011 CARES began expanding
to statewide participation in six states which will
allow additional communities of different sizes and
population densities to be included in the registry In
addition state-level participation will promote better
communication and collaboration between state and
local EMS providers A recent MMWR Surveillance
Summary was published summarizing CARES data
collected during October 1 2005ndashDecember 31
2010 (wwwcdcgovmmwrpdfssss6008pdf) More
information about CARES can be found on the
CARES website at httpsmycaresnet
Paul Coverdell National Acute Stroke Registry
New Registries The Paul Coverdell National
Acute Stroke Registry program successfully
implemented stroke registries in three newly
funded states in 2007 (Michigan Minnesota and
Ohio) These states made much greater progress
in their first year toward developing program
infrastructure collecting data and engaging in
quality improvement activities than had the four
states that completed their first year of Coverdell
Registry funding in 2004 Much of this progress can
be attributed to CDCrsquos increased capacity to provide
proactive technical assistance to states through
conference calls work groups and resource
materials such as the program resource manual
Supplemental Projects The Coverdell Registry
team developed and funded a supplemental
cooperative agreement to pilot the expansion of
the Coverdell Registry model to other domains
within stroke systems of care North Carolina was
funded to demonstrate the feasibility of linking
pre-hospital EMS data for stroke with the state
Coverdell Registry (the North Carolina Stroke
Care Collaborative) In 2010 in partnership with
the Association of State and Territorial Health
Officials CDC funded two Coverdell states to
develop comprehensive statewide stroke care
systems plans CDC is currently funding the Ohio
Coverdell Registry to study 30-day outcomes
of stroke patients based on the quality of care
provided In partnership with the Agency for
Healthcare Research and Quality CDC has funded
an evidence-based review of transitions in care
from hospital to home or rehabilitation for stroke
patients
National Evaluation Plan Through a yearlong
collaboration with RTI International the Coverdell
Registry developed a national evaluation plan The
plan provides a systematic method of assessing
the annual and long-term performance of the
program including strategic goals and objectives
performance goals performance measures and
targets for program outcomes
Consensus Stroke Performance Measures
Endorsement of the Consensus Stroke
Performance Measures The Coverdell Registry
partnered with the American Heart Association
and The Joint Commission to develop performance
measures for acute stroke care commonly
referred to as the Consensus Stroke Performance
Measures These measures were released to
hospitals throughout the United States in fall
2007 In January 2008 more than 1200 hospitals
began using these measures to improve the quality
of care for acute stroke patients The measures
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
11
were submitted to the National Quality Forum in
March 2008 and 8 of the 10 were adopted This
endorsement of the Consensus Stroke Performance
Measures has paved the way for adoption of
these measures by the Centers for Medicare
and Medicaid Services for quality reporting and
meaningful use
Quarterly Data Reports With the implementation
of the Consensus Stroke Performance Measures in
January 2008 CDC began providing states with
quarterly data reports on the measures These
reports provide each state with a summary of its
data on ischemic stroke hemorrhagic stroke and
transient ischemic attacks as well as aggregate data
for all states in the Coverdell Registry program
Applied Research and Evaluation Branch
Building an Economic Evaluation Research Agenda
Based on program needs and research gaps in heart
disease and stroke prevention the Applied Research
and Evaluation Branch developed an agenda to
guide economic research on 1) economic burden
of cardiovascular diseases and cost-effectiveness of
their control 2) economic value of DHDSP-funded
and other state prevention programs 3) CDCrsquos
Internet-based clearinghouse for information on
the economics of cardiovascular diseases and 4)
developing partnerships in economic research to
increase the impact of such research
Stroke Awareness Signs and Symptoms Awareness Campaigns
To provide guidance for state programs a review of
current research on stroke awareness campaigns was
undertaken to identify evidence to support the most
appropriate ways to increase knowledge of signs and
symptoms for stroke the importance of calling 9-1-1
and relationships between the educational campaigns
and outcomes related to awareness of stroke signs
and symptoms
The literature review and synthesis of current
research on stroke awareness campaigns resulted
in the following dissemination activities
bull Development of a fact sheet for state programs on
literature review findings and considerations for
statesrsquo current activities related to stroke awareness
messages including direct education and tools
available to facilitate campaign development
bull Poster presentation at the 2008 National
Conference on Health Communication Marketing
and Media on evaluation guidance for stroke
awareness campaigns The presentation outlined
specific information for states and communities on
how to strengthen the effectiveness and outcome
evaluation of their stroke awareness campaigns
bull Presentation at the 2008 National Heart Disease
and Stroke Prevention Training Institute about
evidence and research on communication and
media campaigns impact considerations of cost
opportunities for partnering and evaluating
results
Comprehensive and Core Indicators
DHDSP released a set of core indicators for
hypertension as part of a comprehensive evidence-
based set of indicators to guide state heart disease
and stroke prevention programs in evaluating their
efforts State health departments received related
key guidance documents training at the National
Heart Disease and Stroke Prevention Training
Institute and a series of follow-up trainings
Indicators are presented in a Consumer Reports
format and rated on multiple dimensions such as
strength of scientific evidence feasibility of data
collection and face validity
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
12
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkitmdash Evaluation Results
CDC worked with the American Institutes for
Research (AIR) to conduct an evaluation of the
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit State health departments
(SHDs) were trained to use the toolkit to promote
state employer-based initiatives on workplace efforts
for heart disease and stroke prevention
From 2005 to 2007 all the SHDs received copies of
the toolkit and were invited to attend training sessions
(one seminar five webinars and three consultations)
To evaluate the usefulness of the toolkit materials
and obtain recommendations two focus groups with
business leaders and Web-based surveys of the SHDs
were conducted In 2006 all 50 states and the District
of Columbia completed the baseline and in 2008 40
states completed the follow-up
Of the 40 SHDs that completed both waves of the
survey the proportion that reported engaging in
employer-based initiatives significantly increased
from 65 percent to 725 percent during the period
examined despite a reported reduction in staff and
limited appropriations About 90 percent of the
SHDs that responded to the 2008 survey are now
working with employers to promote comprehensive
heart disease and stroke prevention programs
disseminate best practices establish employer-
oriented partnerships participate in seminars for
employers and provide business leaders with
resources Partnerships with employer groups or
business coalitions have focused on worksite policy
changes health promotion and education and
worksite surveillance and assessments In parallel
to these experiences the SHDs have increased their
overall level of confidence in their knowledge and
skills Most of the SHDs (61 percent) agreed that
the CDC trainings and consultations helped them
improve their heart disease and stroke prevention
programs and use the toolkit more effectively
Participation in the trainings was positively associated
with engagement in worksite health promotion and
education The SHDs that received federal funding
had significantly higher participation in macro-
marketing activities reaching employers through
business coalitions associations task forces and
champions and were more likely to establish
partnerships with employer groups and government
agencies
The Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit is available at wwwcdc
govdhdsplibrarytoolkitindexhtm
The Branch also provides economics support to
the Division and partners by documenting costs of
cardiovascular diseases and their risk factors and
identifying cost-effective interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
13
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
National Heart Disease and Stroke Prevention Program Overview
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
14
u Blood pressure Prevent and control high blood Program Overview pressure reduce sodium intake
bull In 1998 the US Congress provided funding
for CDC to initiate a national state-based Heart
Disease and Stroke Prevention (HDSP) program in
eight states
bull CDC funds programs in 41 states and the
District of Columbia Twenty-eight are capacity
building (planning) programs and 14 are basic
implementation (intervention) programs
bull Capacity Building Programs Alabama
Alaska Arizona California Colorado Connecticut
District of Columbia Hawaii Idaho Illinois Iowa
Kansas Kentucky Louisiana Maryland Michigan
Minnesota Mississippi Nebraska New Jersey
North Dakota Ohio Oklahoma Oregon Rhode
Island Tennessee Texas and Wisconsin
bull Basic Implementation Programs Arkansas
Florida Georgia Maine Massachusetts Missouri
Montana New York North Carolina South
Carolina Utah Virginia Washington and West
Virginia
National Heart Disease and Stroke Prevention Program Goals bull Enhance state capacity to plan implement track
and sustain population-based interventions to
address heart disease stroke and related risk
factors Focus program efforts on population-
based policy and systems change strategies to
impact the ldquoABCSrdquo of heart disease and stroke
prevention
u Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
u Cholesterol Prevent and control high
cholesterol
u Smoking Increase the number of smokers
counseled to quit and referred to quitlines by
health care workers increase availability of no
or low-cost cessation products and collaborate
with efforts to increase the percentage of the
population protected by smoke-free air laws
and regulations
To a lesser extent state HDSP programs work to
improve emergency response and quality of acute
care systems
State HDSP programs work to eliminate health
disparities in priority populations (ie groups with
increased burden or need based on race ethnicity
gender geography or socioeconomic status) as an
overarching principle
bull Collaborate with chronic disease programs (eg
those focusing on tobacco diabetes physical
inactivity poor nutrition and obesityoverweight)
and partners to develop and integrate population-
based strategies to prevent heart disease and
stroke
bull Promote cardiovascular health in health care
worksite and community settings through policy
and systems changes
bull Identify and evaluate promising practices to
address heart disease and stroke
bull Conduct surveillance of heart disease stroke
and related risk factors
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
15
u
u
Key Responsibilities of State Capacity Building Programs bull Facilitate collaboration with public- and private-
sector partners such as not-for-profit health
agencies health systems organizations emergency
response agencies federally funded health centers
businesses priority population organizations and
voluntary health organizations
bull Document the state burden of heart disease
stroke and related risk factors
bull Develop plans for population-based strategies
for preventing heart disease and stroke among
general and Priority Populations
bull Develop a comprehensive state HDSP plan
bull Develop an HDSP program logic model and
evaluation plan
bull Assess assets and gaps in state policy and systems
related to HDSP in health care worksite and
community settings
Key Responsibilities of State Basic Implementation Programs bull Enhance all capacity-building program activities
bull Implement and evaluate policy systems change
and educational interventions that address the
six HDSP program priority areas in health care
worksite and community settings
bull Provide training and technical assistance to
public health and health care professionals and
partners to support policy and system changes
that will encourage heart disease and stroke
prevention
How CDC Assists State Heart Disease and Stroke Prevention Programs bull Provides training technical assistance and
funding
bull Funds applied research on heart disease and
stroke interventions and elimination of disparities
that is relevant to state programs
bull Identifies and disseminates science-based
promising practices
bull Partners with national organizations to help states
address prevention of heart disease and stroke
bull Facilitates collaborations with other state chronic
disease programs or activities that address risk
factors populations or settings related to heart
disease and stroke prevention and program
priority areas
bull Develops and disseminates publications and tools
such as
u CDCynergy a CD-ROM-based tool for
planning health communication interventions
State Heart Disease and Stroke Prevention
Program Evaluation Framework (wwwcdc
govdhdsplibraryevaluation_framework
indexhtm) a document providing guidance
on systematic ways to measure the success of
public health programs and on logic model
development
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping an
Evaluation Plan (wwwcdcgovDHDSPstate_
programevaluation_guidesevaluation_plan
htm) a document providing guidance on the
development of evaluation activities to help
programs identify required staff time and
resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
16
u
u
u
u
u
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping and
Using a Logic Model (wwwcdcgovDHDSP
state_programevaluation_guideslogic_model
htm) a document providing guidance on
the development and use of logic models as
planning and evaluation tools
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashWriting SMART
Objectives (wwwcdcgovDHDSPstate_
programevaluation_guidessmart_objectives
htm) a document providing guidance to
states on the development of realistic and
measurable objectives
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit (wwwcdcgov
dhdsplibrarytoolkitindexhtm) a document
that provides information materials and
tools that state programs can reference and
distribute to businesses primarily through
employer and professional organizations
Heart Disease and Stroke Interactive Maps
(wwwcdcgovdhdsplibrarymapsstatemaps
htm) which present heart disease and stroke
mortality rates by county for the state racial
ethnic group and gender of the userrsquos choice
A Communication Guide for Policy and
Environmental Change (wwwcdcgovdhdsp
libraryheart_stroke_guideindexhtm) which
includes information references and examples
of communication from state programs and
Stroke Addendum to the Communication
Guide (wwwcdcgovdhdsplibraryheart_
stroke_guideindexhtm)
For additional information please visit the CDC
website at wwwcdcgovdhdsp or contact the
Division for Heart Disease and Stroke Prevention
Program Development and Services Branch at
(770) 488-2424
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
17
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
State Heart Disease and Stroke Prevention Program Funding Opportunity Announcement DP07-704 At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
18
Introduction The Funding Opportunity Announcement
(FOA) DP07-704 At-A-Glance provides important
information to assist programs funded under this
announcement to deliver their program as intended
The At-A-Glance highlights aspects of FOA DP07-704
important for all funded programs including
the following
bull Overview of the National Heart Disease and
Stroke Prevention Program
bull Heart Disease and Stroke Prevention State
Program roles
bull Performance measures for Capacity Building Basic
Implementation Optional Funding for Capacity
Building programs and Stroke Networks
bull Funded program reporting requirements
bull Budgetfunding guidance
bull National and administrative policy requirements
If a program needs a copy of the full document
it should contact its project officer (see Program
Contacts section of the full National Heart Disease
and Stroke Prevention Program Staff Orientation
Manual) to fulfill that request
Section 1 Background In 1998 the US Congress provided funding for
CDC to initiate a national state-based cardiovascular
health program The Senate Appropriations
Committee in 2005 encouraged CDC to create the
Division for Heart Disease and Stroke Prevention and
increased resources enabling CDC to reach 32 of the
50 states and the District of Columbia with funding
for heart disease and stroke prevention As of 2008
the Heart Disease and Stroke Prevention (HDSP)
program funds 41 states and the District of Columbia
As the Division for Heart Disease and Stroke
Prevention developed so did the focus of the State
HDSP Program Focusing on the six program priority
areas (noted below) should impact morbidity and
mortality of these diseases State programs should
increase heart disease and stroke prevention policies
and systems change with the potential to impact
the general population and Priority Populations
(see Prevention Works CDC Strategies for a Heart-
healthy and Stroke-free America wwwCDCgov
dhdsplibrary) For more information on the CDC
State HDSP Program visit wwwcdcgovdhdspState_
programindexhtm
A Public Health Action Plan to Prevent Heart Disease
and Stroke (see wwwCDCgovdhdsplibrary)
documents the multiple intervention opportunities
for preventing heart disease and stroke It is
important to work with partners collaboratively in
leveraging resources to address the multiple risk
factors that are associated with these diseases
Announcement DP07-704 supports program
components considered essential to enhancing
the leadership of state health departments in
heart disease and stroke prevention It provides
for the funding of capacity building and basic
implementation programs as well as projects such as
the Optional Funding for Capacity Building Programs
and Stroke Networks
A capacity building program develops the foundation
for a comprehensive cardiovascular disease prevention
program through such activities as partnership
development definition of the burden and
development of a state plan A basic implementation
program enhances capacity building activities and
implements disseminates and evaluates intervention
activities that address the state plan objectives and the
CDC program priority areas 1ndash6
1 Increase control of high blood pressure primarily
in adults and older adults
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19
2 Increase control of high blood cholesterol
primarily in adults and older adults
3 Increase knowledge of signs and symptoms for
heart attack and stroke and the importance of
calling 9-1-1
4 Improve emergency response
5 Improve quality of heart disease and stroke care
6 Eliminate disparities in terms of race ethnicity
gender geography or socioeconomic status
Optional Funding for Capacity Building Programs
provides support to programs to implement an
evidence-based or promising practice demonstration
project that addresses the CDC program priority
areas 1ndash6
Stroke Networks support a state health department to
increase stroke prevention activities across a group of
three to six contiguous member states with emphasis
on increasing awareness and implementing priority
policy or systems changes across the states
The State HDSP Program is anchored on the
framework of the Socio-ecological Model which
conceptualized the influences of individual
behaviors family and social relationships community
and environmental effects and societal influences
such as policies on health status In order to
promote significant impact for improving the health
of the population interventions should focus on
implementing policy and systems change strategies
that support heart disease and stroke prevention
Policy change can be addressed through a) public
policy (eg establishing certification for hospital-
based stroke centers) or b) organizational policy
(eg businesses providing health benefits plans
that cover preventive services that include blood
pressure control)
System changes are encouraged in three settings
worksites health care and communities An
example of a systems change is when a health
care setting implements electronic records and
patient care management systems that improve the
quality of health care Interventions within systems
are encouraged at the highest level possiblemdashfor
example activities with business coalitions rather
than individual worksites and with managed care
organizations (MCOs) and state medical associations
rather than individual health care sites or physicians
By working at higher levels to affect systems change
states can impact larger segments of the population
Education and awareness efforts to enhance
public understanding and promote actions related
to cardiovascular diseases and the risk factors of
high blood pressure and high cholesterol signs
and symptoms of heart attack and stroke and the
need to call 9-1-1 are also components of capacity
enhancement
An overarching goal of the State HDSP Program
is to address disparities in heart disease and
stroke and the related risk factors using policy and
systems change strategies Based on disparities
(eg raceethnicity gender geographic geography
socioeconomic status) in mortality access to care
or burden of risk factors the State HDSP Program
should identify Priority Populations and implement
interventions to reach those Priority Populations
No one organization will be able to address the
prevention of heart disease and stroke It will require
many organizations working in collaboration if
progress is to be made in accomplishing the Healthy
People 2010 Objectives Collaboration is defined
by the Wilder Foundation as ldquoa mutually beneficial
and well-defined relationship entered into by two
or more organizations to achieve common goals
The relationship includes a commitment to mutual
relationships and goals a jointly developed structure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
20
and shared responsibility mutual authority and
accountability for success and sharing of resources
and rewardsrdquo Developing and maintaining
strategic partnerships are key to the leveraging of
skills and resources to prevent heart disease and
stroke in a comprehensive way The State HDSP
Program has two major roles related to partners
The first is to convene or facilitate collaboration
to develop and implement a comprehensive state
plan and intervention implementation strategies
that addresses heart disease stroke and related
risk factors The second is to develop strategies to
leverage resources and coordinate interventions
with partners that address the six program
priority areas
A logic model has been developed to describe
the State HDSP Program as intended by the CDC
funding to state health departments (see following
page) The model depicts relationships and actions
(eg links between environment and policy
change and individual-level behavioral change)
that are expected to culminate in reduction in
heart disease and stroke
The CDC and state activities are outlined in terms
of capacity building surveillancemonitoring
and interventions Both CDC and state activities
influence changes that lead to short-term
outcomes such as development of a work plan
and strategies for system-level changes effective
implementation of interventions and action by
target audiences and change agents (those who are
in the position to influence policies and systems
such as hospital administrators and MCO decision
makers) These activities and outcomes result in
changes in policy and environmental supports
which in turn influence behavior changes and
improve health status Ultimately these changes
decrease premature death and disability and
eliminate cardiovascular disparities between
general and Priority Populations
The State HDSP logic model also is a tool to guide
program evaluation By identifying the steps
necessary to reach intended outcomes the logic
model provides guidance in evaluating the short and
intermediate outcomes of the program
State evaluation efforts should relate to the National
HDSP Program logic model or to a logic model that
the state develops that complements the national
model and the required program recipient activities
The logic model can also be seen in the CDC
Evaluation Framework for Heart Disease and Stroke
Prevention State Programs at wwwcdcgovdhdsp
Section 2 National Heart Disease and Stroke Prevention State Program Roles In A Public Health Action Plan to Prevent Heart
Disease and Stroke there are four major goals which
are based on Healthy People 2010
Goal 1 Prevention of risk factors
Goal 2 Detection and treatment of risk factors
Goal 3 Early identification and treatment of heart
attacks and strokes
Goal 4 Prevention of recurrent cardiovascular events
CDC-funded State HDSP Programs have a direct
impact on Goals 2 3 and 4 by addressing HDSP
program priority areas 1ndash6 (see Background section)
HDSP programs have a supportive role with other
state health department programs and partners in
addressing Goal 1 Efforts to address Goal 1 related
to tobacco use diabetes obesity poor nutrition
physical inactivity and schools as a worksite should
be done through a supportive or collaborative role
with the state WISEWOMAN diabetes tobacco
nutrition physical activity or coordinated school
health programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
bull State HDSP Programs are encouraged to
coordinate with other programs in ways that
1 Address Goal 1 (eg State HDSP and Nutrition
Programs identify primary prevention messages
related to cholesterol and salt to be included in Nushy
trition Programs where appropriate State HDSP and
Tobacco Programs collaborate to promote use of
state tobacco quit lines State HDSP Program refers
managed care organizations to materials developed
by the Parks and Recreation Department and
Physical Activity Program on safe places to exercise
National HDSP Program Logic Model
State HDSP and WISEWOMAN Programs collaborate
to create systems for educating health care providers
on guidelines focused on risk factor prevention)
2 Enhance inclusion of key messages in the work
of related programs (eg State HDSP Program
works to implement JNC7 guidelines which
include referral to nutrition counseling the
WISEWOMAN Program incorporates education on
signs and symptoms of heart disease and stroke
into ongoing activities the State HDSP Program
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and system change supports
Level bull State bull Local
Settings bull Community bull Health care bull Worksite
Context bull Priority
Populations bull General
populations
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective intervention
implemented focused on
settings and Priority Populations
Change agents
take action
Activate intended audiences
Capa
city B
uildin
gSu
rveil
lance
Inter
vent
ions
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
21
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
3
and stroke DHDSP staff collaborate with national
public- and private-sector partners to plan direct
and coordinate programs and research that reduce
risk factors disease deaths and disparities associated
with heart disease and stroke
DHDSP provides national leadership in addressing
key issues such as sodium consumption awareness
of signs and symptoms of heart attack and stroke
and access to screening and interventions for
cardiovascular problems The results of DHDSPrsquos
work are often highlighted in the national media
have gained widespread exposure on the Internet
and have been published in professional and peer-
reviewed journals and publications
The National Forum for Heart Disease and Stroke Prevention CDC the American Heart Association and the
Association of State and Territorial Health Officials
led the development of the landmark publication
A Public Health Action Plan to Prevent Heart
Disease and Stroke (Action Plan) The National
Forum for Heart Disease and Stroke Prevention
was convened to review draft recommendations
for the Action Plan in September 2002 and in
2003 it became a major vehicle for implementing
the plan This national coalition now representing
more than 80 organizations provides strategic
guidance on heart disease and stroke prevention
activities through the Action Plan and promotes
collaboration through an annual meeting held in
Washington DC and face-to-face meetings with
each of its seven implementation work groups The
Action Plan provides states organizations and key
stakeholders with a framework for planning public
health strategies to prevent heart disease and stroke
throughout the nation
DHDSP Goals 1 Prevent risk factors for heart disease and stroke
2 Increase detection and treatment of risk factors
for heart disease and stroke
3 Increase early identification and treatment of heart
disease and stroke
4 Decrease recurrences of cardiovascular events
5 Foster a skilled and engaged public health
workforce to address heart disease and stroke
Organization and Staffing
DHDSP Structure
DHDSP consists of the Office of the Director
(OD) and three branches the Applied Research
and Evaluation Branch (AREB) the Epidemiology
and Surveillance Branch (ESB) and the Program
Development and Services Branch (PDSB)
office of the Director OD is responsible for resource management research
coordination communications partnership building
external affairs coordination of policy and legislative
activities and global collaborations OD staff
participate in and manage activities related to
Division partnerships such as CDCrsquos Cardiovascular
Health Collaboration the National Forum and the
Healthy People 2010 Partnership
Program Development and services Branch PDSB promotes evidence-based strategies and
programs to reduce health disparities and prevent
heart disease and stroke throughout the nation It
funds and manages cooperative agreements with
states tribal organizations and partners and provides
technical assistance to staff in the National Heart
Disease and Stroke Prevention Program PDSB
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
DHDSP Organizational Structure
Office of the Director
Deputy Director Administrative Office
Associate Director for Science
Strategic Planning Partnerships and External Relations
Global Health Coordinator
Epidemiology and Surveillance Branch
Program Development and Services Branch
WISEWOMAN Team
Senior Advisor to Division Director
Applied Research and Evaluation Branch
Planning Partnerships and Policy Team
Health Communication and Program Information Team
Statistical Unit
Epidemiology and Surveillance Team
Small Area Analysis Team
Health Services Research and Registries Team
Program Services Team Applied Research and Translation Team
Evaluation and Program Effectiveness Team
4
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
5
provides grantees with comprehensive technical
assistance training and programmatic tools and
guidance for the development implementation
and evaluation of programs Together with related
programs across NCCDPHP PDSB provides
leadership to ensure collaboration that can affect
heart disease and stroke prevention outcomes
epidemiology and surveillance Branch ESB studies patterns and trends in the following areas
as they relate to cardiovascular diseases risk factors
costs health behaviors and outcomes barriers to
patient access to care public awareness geographic
variation and disparity of cardiovascular disease
rates among races and ethnic groups These scientific
findings allow DHDSP and its partners to respond
to emerging health risks and promote public health
practice ESB funds and manages the Paul Coverdell
National Acute Stroke Registry Staff provide technical
assistance and expertise through scientific articles
research findings geographic information system
mapping and promotion of new surveillance
methods and technologies
applied research and evaluation Branch AREB works with states partners and colleagues to
conduct and translate applied research and evaluation
of heart disease and stroke prevention efforts It
evaluates programs policies and interventions to
ensure they are working as planned and producing
the intended results It promotes evidence-based
practice by translating scientific findings into practical
resources and tools for public health practitioners
health care providers and others working to prevent
heart disease and stroke In addition AREB supports
state program activities through technical assistance
guidance resource development and capacity
building for applied research and evaluation
Funded Programs DHDSP funds and supports three national heart
disease and stroke prevention programs The fiscal
year 2010 appropriation was $56 million for heart
disease and stroke prevention programs Funds
are awarded through a competitive process for
the National Heart Disease and Stroke Prevention
Program Paul Coverdell National Acute Stroke
Registry and Sodium Reduction in Communities
Program
National Heart Disease and Stroke Prevention Program
The National Heart Disease and Stroke Prevention
Program provides funding and support to state
health departments to manage heart disease and
stroke prevention programs at the state and local
levels DHDSP shares the latest science and practices
with states to help reduce disease deaths and
health disparities related to heart disease and stroke
especially among those at high risk The program
has grown from funding 8 states in 1998 to funding
41 states and the District of Columbia in the current
funding cycle Twenty-eight states are funded for
capacity building and 14 for basic implementation
CDC-funded state programs promote changes to
policies and systems in health care worksite and
community settings and the elimination of health
disparities by emphasizing the ABCS of heart
disease and stroke prevention Some programs also
work to improve emergency response and quality
of acute care
WISEWOMAN
The Well-Integrated Screening and Evaluation for
WOMen Across the Nation (WISEWOMAN) Program
helps women with little or no health insurance
access services that can help reduce their risk for
heart disease stroke and other chronic diseases
The priority age group is women aged 40ndash64 years
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
6
2010 Funded Programs
2011 Funded Programs
NHDSP Funded States
WISEWOMAN Programs
WA
MT
ID WY
NV
AK
HI
AZ NM
TX
KSCO
OK
SD
ND
AR
IN OH
KY
TN
LA ALMS
FL
GA
NY
ME
OR
UT
CA
NE IA
MO
WI
IL
MN
MI
VAWV
SC
NC
PA NH
DE
VT
MD
NJ
RI
DC
MA
CT
Coverdell Stroke Registry States
Sodium Reduction Communities
Unfunded States
Note WISEWOMAN funds two tribal organizations in Alaska but not the state health department
Congress authorized the program in 1993 as an
expansion of services offered through the National
Breast and Cervical Cancer Early Detection Program
DHDSP funds WISEWOMAN programs in 19 states
and 2 tribal organizations Working in local clinics
and health care settings WISEWOMAN provides
heart disease and stroke risk factor screenings and
offers lifestyle interventions to help women increase
their physical activity improve their diet and engage
in tobacco cessation efforts
Paul Coverdell National Acute Stroke Registry
DHDSP funds states to establish surveillance systems
that measure track and provide data to help improve
the delivery and quality of stroke care among acute
stroke patients In 2001 Congress funded CDC to
establish the Paul Coverdell National Acute Stroke
Registry after US Senator Paul Coverdell of Georgia
suffered a fatal stroke while serving in Congress
The goal of the Coverdell Registry is to ensure that
all stroke patients receive the highest quality acute
stroke care available to reduce untimely deaths
prevent disability and avoid recurrent strokes With
Coverdell Registry data states and their health care
partners identify and analyze gaps in stroke care
systems and plan targeted strategies to address
them In June 2004 CDC funded four state health
departments (Georgia Illinois Massachusetts
and North Carolina) to establish Paul Coverdell
National Acute Stroke Registries In the most recent
Paul Coverdell National Acute Stroke Registry
funding cycle (2007ndash2011) CDC funded state health
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
7
departments in Georgia Massachusetts Michigan
Minnesota Ohio and North Carolina In 2007
CDC The Joint Commissionrsquos Primary Stroke Center
Certification program and the American Heart
AssociationAmerican Stroke Associationrsquos Get With
The Guidelinesreg-Stroke program jointly released a set
of standardized stroke performance measures to be
used by all three programs This effort has reduced
duplication of effort increased collaboration and
encouraged hospitals to participate in the programs
Office of the Director
Mississippi Delta Health Collaborative (Delta Health Initiative)
The Mississippi Delta Health Collaborative (MDHC)
is designed to prevent heart disease stroke and
related chronic diseases Through a new five-year
cooperative agreement this initiative will intensify
collaboration among the Mississippi Department of
Health existing chronic disease programs (eg heart
disease and stroke prevention diabetes tobacco
nutrition physical activity) local health departments
other community health care providers (eg
federally qualified health centers) local communities
and CDC This result will be achieved through
implementation of interventions across Mississippirsquos
18-county Delta Region The program will target
the ldquoABCSrdquo of heart disease and stroke prevention
among priority populations in high burden
underserved rural areas
bull Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
bull Hemoglobin A1c (HbA1c) Monitor and control
blood glucose
bull Blood pressure Prevent and control high blood
pressure
bull Cholesterol Prevent and control high LDL-
cholesterol
bull Smoking Prevent initiation and increase cessation
of smoking and increase the percentage of the
population protected by smoke-free air laws or
regulations
The Mississippi Department of Health will provide
leadership and funding support in the Delta
Region to implement prioritized population-based
interventions policy systems and environmental
change selected as appropriate from a set of
prescribed evidence-based strategies in both the
clinical and community settings
WISEWOMAN
The WISEWOMAN Program began a new five-
year funding cycle June 30 2008 The competitive
application process resulted in 21 programs being
funded This is an increase of six programs from the
previous funding cycle Seventeen WISEWOMAN
programs also receive funding to implement the
National Heart Disease and Stroke Prevention
Program
One major focus of the funding opportunity
announcement (FOA) is development of partnerships
At a minimum funded programs are expected to
partner with their statetribal Breast and Cervical
Cancer Early Detection Program Tobacco Control
Program Heart Disease and Stroke Prevention
ProgramCoalition and other programs that
can affect policies and environments in which
WISEWOMAN participants live work and play
Because the majority of WISEWOMAN funding must
be spent on providing direct services to women
partnerships are extremely important to ensure
participant access to affordable and quality resources
to support heart health
WISEWOMAN evaluation emphasizes program
improvement and is based on the CDC Framework
for Program Evaluation in Public Health CDC has
developed key evaluation questions related to the
programrsquos stated goals and logic model components
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
8
The questions are used in the evaluation of the
WISEWOMAN Program Funded programs are
required to conduct evaluations to assess progress
toward meeting stated work plan objectives and to
share results with others including their providers
partners other stakeholders and CDC Funded
programs contribute to the WISEWOMAN Program
evaluation by providing Minimum Data Elements
data submitting information to CDC that supports
program evaluation activities and participating in
activities such as site visits and case studies
Sodium Reduction in Communities
High sodium consumption is a major contributor
to high blood pressure a leading cause of stroke
coronary heart disease heart attack and heart and
kidney failure in the United States The 2010 Dietary
Guidelines for Americans recommend limiting
sodium to less than 2300 milligrams (mg) per day
Individuals who are 51 and older and those of any
age who are African American or have hypertension
diabetes or chronic kidney disease should limit
intake to 1500 mg of sodium per day These groups
account for about half the US population and the
majority of adults
Studies show that on average US adults consume
more than 3400 mg of sodium per day An estimated
77 percent of sodium comes from processed and
restaurant foods Reducing dietary intake of sodium
to 2300 mg per day could prevent as many as 11
million cases of hypertension in the United States
Further reductions in sodium intake to 1500 mg per
day could prevent more than 16 million cases
Through the three-year Sodium Reduction in
Communities cooperative agreement which began in
September 2010 DHDSP is providing support to six
communities to support policy changes designed to
create healthier food environments The communities
receiving support include California (Shasta County)
Kansas (Shawnee County) Los Angeles County
New York City and New York State (Broome and
Schenectady counties)
Program Development and Services Branch
Funded State Programs
National Heart Disease and Stroke Prevention Program The enhanced reach of the National
Heart Disease and Stroke Prevention Program was
a key accomplishment in 2008 Eight new states
(Connecticut Hawaii Idaho Iowa Maryland New
Jersey North Dakota and West Virginia) were funded
as part of the program bringing the total number of
funded programs to 42
Leadership to Center Integration PDSB has
provided leadership to NCCDPHPrsquos initiative to
increase synergy reach and desired health outcomes
in selected NCCDPHP-funded categorical programs
(National Heart Disease and Stroke Prevention
Diabetes Prevention and Control Tobacco Control
Comprehensive Cancer Control Nutrition Physical
Activity and Obesity and the Behavioral Risk Factor
Surveillance System)
National Training DHDSP conducted the 2008
National Heart Disease and Stroke Prevention
Training Institute on September 9ndash11 in Atlanta The
training focused on longer skill-building interactive
workshops that addressed the competencies
program priorities and performance measures of
the FOAs for DHDSPrsquos funded programs It included
the National Heart Disease and Stroke Prevention
Program and WISEWOMAN and was expanded to
include representation from each statersquos heart disease
program as well as American Heart Association
field staff working in the states Informal feedback
indicates that the training has already led to greater
collaboration at the state level
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
9
Management Information System (MIS) In 2008
DHDSP completed revisions for the heart disease
and stroke prevention Web-based MIS The report
generated by the system was changed to a table that
displays an objective time frame status and progress
in an easy-to-read format These changes made the
system more user friendly for states and CDC The
MIS can now be used to
bull Describe state program activities and expected
use of CDC funds
bull Track progress on state program activities and
identify promising practices
bull Assist CDC in identifying the need for training
and technical assistance
bull Standardize the state reporting process to
facilitate evaluation
bull Enable CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Funded Partnerships
Directors of Health Promotion and Education
(DHPE) In 2008 DHDSP continued to support
the DHPECDC Internship Program for Students
of Minority Serving Institutions
National Stroke Association DHDSP assisted with
funding for the Sixth Annual National Public Health
Stroke Summit conducted by the National Stroke
Association in Denver Colorado in December 2007
The Summit brought together 105 state public health
and health care professionals to promote information
sharing knowledge and skill building networking
and partnership development
National Collaborations
Cardiovascular Health (CVH) Council of the National Association of Chronic Disease Directors (NACDD) In 2008 the CVH Council
updated its section of the NACDD website to include
additional materials useful to states and it started
a Web discussion forum that allows states to share
ideas and products The Council obtained private
funds and sponsored the 2-day Northeast Regional
Workshop on Cholesterol Control in which 11
states participated in May 2008 It also funded two
of the participating states (Maine and Maryland)
to do follow-up work on cholesterol control with
their primary care associations and local federally
qualified health centers In March 2008 the
Council led the development of a themed issue of
the e-journal Preventing Chronic Disease In most
cases state program staff coauthored articles with
DHDSP staff The CVH Council worked with DHDSP
to assess the training needs of state programs in
the National Heart Disease and Stroke Prevention
Program and DHDSP used this information to plan
its September 2008 3-day training workshop for state
program and WISEWOMAN staff
Epidemiology and Surveillance Branch
Cardiac Arrest Registry to Enhance Survival
The Cardiac Arrest Registry to Enhance Survival
(CARES) began in 2005 in Atlanta and has since
expanded to 40 communities in 23 states CARES is
a simple but robust registry of cardiac arrest events
that allows participating sites to enter data related
to out-of-hospital cardiac arrest (OHCA) generate
summary reports and compare local data with
similar EMS systems elsewhere Three sources of
data are linked to describe each OHCA event 1)
9-1-1 call center data (to provide incident address
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
10
and dispatch and arrival times) 2) EMS data (to
describe initially recorded cardiac rhythm and
treatment methods) and 3) hospital data (emergency
department and hospital outcome hypothermia
treatment and neurologic status at discharge)
Multiple reporting features can be generated and
monitored continuously through secure online access
by CARES participants which allows for longitudinal
internal benchmarking Local EMS administrators
and medical directors are able to identify when and
where cardiac arrests occur which elements of their
EMS system are functioning properly in dealing
with these cases and what changes can be made to
improve outcomes In 2011 CARES began expanding
to statewide participation in six states which will
allow additional communities of different sizes and
population densities to be included in the registry In
addition state-level participation will promote better
communication and collaboration between state and
local EMS providers A recent MMWR Surveillance
Summary was published summarizing CARES data
collected during October 1 2005ndashDecember 31
2010 (wwwcdcgovmmwrpdfssss6008pdf) More
information about CARES can be found on the
CARES website at httpsmycaresnet
Paul Coverdell National Acute Stroke Registry
New Registries The Paul Coverdell National
Acute Stroke Registry program successfully
implemented stroke registries in three newly
funded states in 2007 (Michigan Minnesota and
Ohio) These states made much greater progress
in their first year toward developing program
infrastructure collecting data and engaging in
quality improvement activities than had the four
states that completed their first year of Coverdell
Registry funding in 2004 Much of this progress can
be attributed to CDCrsquos increased capacity to provide
proactive technical assistance to states through
conference calls work groups and resource
materials such as the program resource manual
Supplemental Projects The Coverdell Registry
team developed and funded a supplemental
cooperative agreement to pilot the expansion of
the Coverdell Registry model to other domains
within stroke systems of care North Carolina was
funded to demonstrate the feasibility of linking
pre-hospital EMS data for stroke with the state
Coverdell Registry (the North Carolina Stroke
Care Collaborative) In 2010 in partnership with
the Association of State and Territorial Health
Officials CDC funded two Coverdell states to
develop comprehensive statewide stroke care
systems plans CDC is currently funding the Ohio
Coverdell Registry to study 30-day outcomes
of stroke patients based on the quality of care
provided In partnership with the Agency for
Healthcare Research and Quality CDC has funded
an evidence-based review of transitions in care
from hospital to home or rehabilitation for stroke
patients
National Evaluation Plan Through a yearlong
collaboration with RTI International the Coverdell
Registry developed a national evaluation plan The
plan provides a systematic method of assessing
the annual and long-term performance of the
program including strategic goals and objectives
performance goals performance measures and
targets for program outcomes
Consensus Stroke Performance Measures
Endorsement of the Consensus Stroke
Performance Measures The Coverdell Registry
partnered with the American Heart Association
and The Joint Commission to develop performance
measures for acute stroke care commonly
referred to as the Consensus Stroke Performance
Measures These measures were released to
hospitals throughout the United States in fall
2007 In January 2008 more than 1200 hospitals
began using these measures to improve the quality
of care for acute stroke patients The measures
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
11
were submitted to the National Quality Forum in
March 2008 and 8 of the 10 were adopted This
endorsement of the Consensus Stroke Performance
Measures has paved the way for adoption of
these measures by the Centers for Medicare
and Medicaid Services for quality reporting and
meaningful use
Quarterly Data Reports With the implementation
of the Consensus Stroke Performance Measures in
January 2008 CDC began providing states with
quarterly data reports on the measures These
reports provide each state with a summary of its
data on ischemic stroke hemorrhagic stroke and
transient ischemic attacks as well as aggregate data
for all states in the Coverdell Registry program
Applied Research and Evaluation Branch
Building an Economic Evaluation Research Agenda
Based on program needs and research gaps in heart
disease and stroke prevention the Applied Research
and Evaluation Branch developed an agenda to
guide economic research on 1) economic burden
of cardiovascular diseases and cost-effectiveness of
their control 2) economic value of DHDSP-funded
and other state prevention programs 3) CDCrsquos
Internet-based clearinghouse for information on
the economics of cardiovascular diseases and 4)
developing partnerships in economic research to
increase the impact of such research
Stroke Awareness Signs and Symptoms Awareness Campaigns
To provide guidance for state programs a review of
current research on stroke awareness campaigns was
undertaken to identify evidence to support the most
appropriate ways to increase knowledge of signs and
symptoms for stroke the importance of calling 9-1-1
and relationships between the educational campaigns
and outcomes related to awareness of stroke signs
and symptoms
The literature review and synthesis of current
research on stroke awareness campaigns resulted
in the following dissemination activities
bull Development of a fact sheet for state programs on
literature review findings and considerations for
statesrsquo current activities related to stroke awareness
messages including direct education and tools
available to facilitate campaign development
bull Poster presentation at the 2008 National
Conference on Health Communication Marketing
and Media on evaluation guidance for stroke
awareness campaigns The presentation outlined
specific information for states and communities on
how to strengthen the effectiveness and outcome
evaluation of their stroke awareness campaigns
bull Presentation at the 2008 National Heart Disease
and Stroke Prevention Training Institute about
evidence and research on communication and
media campaigns impact considerations of cost
opportunities for partnering and evaluating
results
Comprehensive and Core Indicators
DHDSP released a set of core indicators for
hypertension as part of a comprehensive evidence-
based set of indicators to guide state heart disease
and stroke prevention programs in evaluating their
efforts State health departments received related
key guidance documents training at the National
Heart Disease and Stroke Prevention Training
Institute and a series of follow-up trainings
Indicators are presented in a Consumer Reports
format and rated on multiple dimensions such as
strength of scientific evidence feasibility of data
collection and face validity
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
12
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkitmdash Evaluation Results
CDC worked with the American Institutes for
Research (AIR) to conduct an evaluation of the
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit State health departments
(SHDs) were trained to use the toolkit to promote
state employer-based initiatives on workplace efforts
for heart disease and stroke prevention
From 2005 to 2007 all the SHDs received copies of
the toolkit and were invited to attend training sessions
(one seminar five webinars and three consultations)
To evaluate the usefulness of the toolkit materials
and obtain recommendations two focus groups with
business leaders and Web-based surveys of the SHDs
were conducted In 2006 all 50 states and the District
of Columbia completed the baseline and in 2008 40
states completed the follow-up
Of the 40 SHDs that completed both waves of the
survey the proportion that reported engaging in
employer-based initiatives significantly increased
from 65 percent to 725 percent during the period
examined despite a reported reduction in staff and
limited appropriations About 90 percent of the
SHDs that responded to the 2008 survey are now
working with employers to promote comprehensive
heart disease and stroke prevention programs
disseminate best practices establish employer-
oriented partnerships participate in seminars for
employers and provide business leaders with
resources Partnerships with employer groups or
business coalitions have focused on worksite policy
changes health promotion and education and
worksite surveillance and assessments In parallel
to these experiences the SHDs have increased their
overall level of confidence in their knowledge and
skills Most of the SHDs (61 percent) agreed that
the CDC trainings and consultations helped them
improve their heart disease and stroke prevention
programs and use the toolkit more effectively
Participation in the trainings was positively associated
with engagement in worksite health promotion and
education The SHDs that received federal funding
had significantly higher participation in macro-
marketing activities reaching employers through
business coalitions associations task forces and
champions and were more likely to establish
partnerships with employer groups and government
agencies
The Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit is available at wwwcdc
govdhdsplibrarytoolkitindexhtm
The Branch also provides economics support to
the Division and partners by documenting costs of
cardiovascular diseases and their risk factors and
identifying cost-effective interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
13
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
National Heart Disease and Stroke Prevention Program Overview
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
14
u Blood pressure Prevent and control high blood Program Overview pressure reduce sodium intake
bull In 1998 the US Congress provided funding
for CDC to initiate a national state-based Heart
Disease and Stroke Prevention (HDSP) program in
eight states
bull CDC funds programs in 41 states and the
District of Columbia Twenty-eight are capacity
building (planning) programs and 14 are basic
implementation (intervention) programs
bull Capacity Building Programs Alabama
Alaska Arizona California Colorado Connecticut
District of Columbia Hawaii Idaho Illinois Iowa
Kansas Kentucky Louisiana Maryland Michigan
Minnesota Mississippi Nebraska New Jersey
North Dakota Ohio Oklahoma Oregon Rhode
Island Tennessee Texas and Wisconsin
bull Basic Implementation Programs Arkansas
Florida Georgia Maine Massachusetts Missouri
Montana New York North Carolina South
Carolina Utah Virginia Washington and West
Virginia
National Heart Disease and Stroke Prevention Program Goals bull Enhance state capacity to plan implement track
and sustain population-based interventions to
address heart disease stroke and related risk
factors Focus program efforts on population-
based policy and systems change strategies to
impact the ldquoABCSrdquo of heart disease and stroke
prevention
u Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
u Cholesterol Prevent and control high
cholesterol
u Smoking Increase the number of smokers
counseled to quit and referred to quitlines by
health care workers increase availability of no
or low-cost cessation products and collaborate
with efforts to increase the percentage of the
population protected by smoke-free air laws
and regulations
To a lesser extent state HDSP programs work to
improve emergency response and quality of acute
care systems
State HDSP programs work to eliminate health
disparities in priority populations (ie groups with
increased burden or need based on race ethnicity
gender geography or socioeconomic status) as an
overarching principle
bull Collaborate with chronic disease programs (eg
those focusing on tobacco diabetes physical
inactivity poor nutrition and obesityoverweight)
and partners to develop and integrate population-
based strategies to prevent heart disease and
stroke
bull Promote cardiovascular health in health care
worksite and community settings through policy
and systems changes
bull Identify and evaluate promising practices to
address heart disease and stroke
bull Conduct surveillance of heart disease stroke
and related risk factors
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
15
u
u
Key Responsibilities of State Capacity Building Programs bull Facilitate collaboration with public- and private-
sector partners such as not-for-profit health
agencies health systems organizations emergency
response agencies federally funded health centers
businesses priority population organizations and
voluntary health organizations
bull Document the state burden of heart disease
stroke and related risk factors
bull Develop plans for population-based strategies
for preventing heart disease and stroke among
general and Priority Populations
bull Develop a comprehensive state HDSP plan
bull Develop an HDSP program logic model and
evaluation plan
bull Assess assets and gaps in state policy and systems
related to HDSP in health care worksite and
community settings
Key Responsibilities of State Basic Implementation Programs bull Enhance all capacity-building program activities
bull Implement and evaluate policy systems change
and educational interventions that address the
six HDSP program priority areas in health care
worksite and community settings
bull Provide training and technical assistance to
public health and health care professionals and
partners to support policy and system changes
that will encourage heart disease and stroke
prevention
How CDC Assists State Heart Disease and Stroke Prevention Programs bull Provides training technical assistance and
funding
bull Funds applied research on heart disease and
stroke interventions and elimination of disparities
that is relevant to state programs
bull Identifies and disseminates science-based
promising practices
bull Partners with national organizations to help states
address prevention of heart disease and stroke
bull Facilitates collaborations with other state chronic
disease programs or activities that address risk
factors populations or settings related to heart
disease and stroke prevention and program
priority areas
bull Develops and disseminates publications and tools
such as
u CDCynergy a CD-ROM-based tool for
planning health communication interventions
State Heart Disease and Stroke Prevention
Program Evaluation Framework (wwwcdc
govdhdsplibraryevaluation_framework
indexhtm) a document providing guidance
on systematic ways to measure the success of
public health programs and on logic model
development
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping an
Evaluation Plan (wwwcdcgovDHDSPstate_
programevaluation_guidesevaluation_plan
htm) a document providing guidance on the
development of evaluation activities to help
programs identify required staff time and
resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
16
u
u
u
u
u
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping and
Using a Logic Model (wwwcdcgovDHDSP
state_programevaluation_guideslogic_model
htm) a document providing guidance on
the development and use of logic models as
planning and evaluation tools
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashWriting SMART
Objectives (wwwcdcgovDHDSPstate_
programevaluation_guidessmart_objectives
htm) a document providing guidance to
states on the development of realistic and
measurable objectives
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit (wwwcdcgov
dhdsplibrarytoolkitindexhtm) a document
that provides information materials and
tools that state programs can reference and
distribute to businesses primarily through
employer and professional organizations
Heart Disease and Stroke Interactive Maps
(wwwcdcgovdhdsplibrarymapsstatemaps
htm) which present heart disease and stroke
mortality rates by county for the state racial
ethnic group and gender of the userrsquos choice
A Communication Guide for Policy and
Environmental Change (wwwcdcgovdhdsp
libraryheart_stroke_guideindexhtm) which
includes information references and examples
of communication from state programs and
Stroke Addendum to the Communication
Guide (wwwcdcgovdhdsplibraryheart_
stroke_guideindexhtm)
For additional information please visit the CDC
website at wwwcdcgovdhdsp or contact the
Division for Heart Disease and Stroke Prevention
Program Development and Services Branch at
(770) 488-2424
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
17
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
State Heart Disease and Stroke Prevention Program Funding Opportunity Announcement DP07-704 At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
18
Introduction The Funding Opportunity Announcement
(FOA) DP07-704 At-A-Glance provides important
information to assist programs funded under this
announcement to deliver their program as intended
The At-A-Glance highlights aspects of FOA DP07-704
important for all funded programs including
the following
bull Overview of the National Heart Disease and
Stroke Prevention Program
bull Heart Disease and Stroke Prevention State
Program roles
bull Performance measures for Capacity Building Basic
Implementation Optional Funding for Capacity
Building programs and Stroke Networks
bull Funded program reporting requirements
bull Budgetfunding guidance
bull National and administrative policy requirements
If a program needs a copy of the full document
it should contact its project officer (see Program
Contacts section of the full National Heart Disease
and Stroke Prevention Program Staff Orientation
Manual) to fulfill that request
Section 1 Background In 1998 the US Congress provided funding for
CDC to initiate a national state-based cardiovascular
health program The Senate Appropriations
Committee in 2005 encouraged CDC to create the
Division for Heart Disease and Stroke Prevention and
increased resources enabling CDC to reach 32 of the
50 states and the District of Columbia with funding
for heart disease and stroke prevention As of 2008
the Heart Disease and Stroke Prevention (HDSP)
program funds 41 states and the District of Columbia
As the Division for Heart Disease and Stroke
Prevention developed so did the focus of the State
HDSP Program Focusing on the six program priority
areas (noted below) should impact morbidity and
mortality of these diseases State programs should
increase heart disease and stroke prevention policies
and systems change with the potential to impact
the general population and Priority Populations
(see Prevention Works CDC Strategies for a Heart-
healthy and Stroke-free America wwwCDCgov
dhdsplibrary) For more information on the CDC
State HDSP Program visit wwwcdcgovdhdspState_
programindexhtm
A Public Health Action Plan to Prevent Heart Disease
and Stroke (see wwwCDCgovdhdsplibrary)
documents the multiple intervention opportunities
for preventing heart disease and stroke It is
important to work with partners collaboratively in
leveraging resources to address the multiple risk
factors that are associated with these diseases
Announcement DP07-704 supports program
components considered essential to enhancing
the leadership of state health departments in
heart disease and stroke prevention It provides
for the funding of capacity building and basic
implementation programs as well as projects such as
the Optional Funding for Capacity Building Programs
and Stroke Networks
A capacity building program develops the foundation
for a comprehensive cardiovascular disease prevention
program through such activities as partnership
development definition of the burden and
development of a state plan A basic implementation
program enhances capacity building activities and
implements disseminates and evaluates intervention
activities that address the state plan objectives and the
CDC program priority areas 1ndash6
1 Increase control of high blood pressure primarily
in adults and older adults
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19
2 Increase control of high blood cholesterol
primarily in adults and older adults
3 Increase knowledge of signs and symptoms for
heart attack and stroke and the importance of
calling 9-1-1
4 Improve emergency response
5 Improve quality of heart disease and stroke care
6 Eliminate disparities in terms of race ethnicity
gender geography or socioeconomic status
Optional Funding for Capacity Building Programs
provides support to programs to implement an
evidence-based or promising practice demonstration
project that addresses the CDC program priority
areas 1ndash6
Stroke Networks support a state health department to
increase stroke prevention activities across a group of
three to six contiguous member states with emphasis
on increasing awareness and implementing priority
policy or systems changes across the states
The State HDSP Program is anchored on the
framework of the Socio-ecological Model which
conceptualized the influences of individual
behaviors family and social relationships community
and environmental effects and societal influences
such as policies on health status In order to
promote significant impact for improving the health
of the population interventions should focus on
implementing policy and systems change strategies
that support heart disease and stroke prevention
Policy change can be addressed through a) public
policy (eg establishing certification for hospital-
based stroke centers) or b) organizational policy
(eg businesses providing health benefits plans
that cover preventive services that include blood
pressure control)
System changes are encouraged in three settings
worksites health care and communities An
example of a systems change is when a health
care setting implements electronic records and
patient care management systems that improve the
quality of health care Interventions within systems
are encouraged at the highest level possiblemdashfor
example activities with business coalitions rather
than individual worksites and with managed care
organizations (MCOs) and state medical associations
rather than individual health care sites or physicians
By working at higher levels to affect systems change
states can impact larger segments of the population
Education and awareness efforts to enhance
public understanding and promote actions related
to cardiovascular diseases and the risk factors of
high blood pressure and high cholesterol signs
and symptoms of heart attack and stroke and the
need to call 9-1-1 are also components of capacity
enhancement
An overarching goal of the State HDSP Program
is to address disparities in heart disease and
stroke and the related risk factors using policy and
systems change strategies Based on disparities
(eg raceethnicity gender geographic geography
socioeconomic status) in mortality access to care
or burden of risk factors the State HDSP Program
should identify Priority Populations and implement
interventions to reach those Priority Populations
No one organization will be able to address the
prevention of heart disease and stroke It will require
many organizations working in collaboration if
progress is to be made in accomplishing the Healthy
People 2010 Objectives Collaboration is defined
by the Wilder Foundation as ldquoa mutually beneficial
and well-defined relationship entered into by two
or more organizations to achieve common goals
The relationship includes a commitment to mutual
relationships and goals a jointly developed structure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
20
and shared responsibility mutual authority and
accountability for success and sharing of resources
and rewardsrdquo Developing and maintaining
strategic partnerships are key to the leveraging of
skills and resources to prevent heart disease and
stroke in a comprehensive way The State HDSP
Program has two major roles related to partners
The first is to convene or facilitate collaboration
to develop and implement a comprehensive state
plan and intervention implementation strategies
that addresses heart disease stroke and related
risk factors The second is to develop strategies to
leverage resources and coordinate interventions
with partners that address the six program
priority areas
A logic model has been developed to describe
the State HDSP Program as intended by the CDC
funding to state health departments (see following
page) The model depicts relationships and actions
(eg links between environment and policy
change and individual-level behavioral change)
that are expected to culminate in reduction in
heart disease and stroke
The CDC and state activities are outlined in terms
of capacity building surveillancemonitoring
and interventions Both CDC and state activities
influence changes that lead to short-term
outcomes such as development of a work plan
and strategies for system-level changes effective
implementation of interventions and action by
target audiences and change agents (those who are
in the position to influence policies and systems
such as hospital administrators and MCO decision
makers) These activities and outcomes result in
changes in policy and environmental supports
which in turn influence behavior changes and
improve health status Ultimately these changes
decrease premature death and disability and
eliminate cardiovascular disparities between
general and Priority Populations
The State HDSP logic model also is a tool to guide
program evaluation By identifying the steps
necessary to reach intended outcomes the logic
model provides guidance in evaluating the short and
intermediate outcomes of the program
State evaluation efforts should relate to the National
HDSP Program logic model or to a logic model that
the state develops that complements the national
model and the required program recipient activities
The logic model can also be seen in the CDC
Evaluation Framework for Heart Disease and Stroke
Prevention State Programs at wwwcdcgovdhdsp
Section 2 National Heart Disease and Stroke Prevention State Program Roles In A Public Health Action Plan to Prevent Heart
Disease and Stroke there are four major goals which
are based on Healthy People 2010
Goal 1 Prevention of risk factors
Goal 2 Detection and treatment of risk factors
Goal 3 Early identification and treatment of heart
attacks and strokes
Goal 4 Prevention of recurrent cardiovascular events
CDC-funded State HDSP Programs have a direct
impact on Goals 2 3 and 4 by addressing HDSP
program priority areas 1ndash6 (see Background section)
HDSP programs have a supportive role with other
state health department programs and partners in
addressing Goal 1 Efforts to address Goal 1 related
to tobacco use diabetes obesity poor nutrition
physical inactivity and schools as a worksite should
be done through a supportive or collaborative role
with the state WISEWOMAN diabetes tobacco
nutrition physical activity or coordinated school
health programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
bull State HDSP Programs are encouraged to
coordinate with other programs in ways that
1 Address Goal 1 (eg State HDSP and Nutrition
Programs identify primary prevention messages
related to cholesterol and salt to be included in Nushy
trition Programs where appropriate State HDSP and
Tobacco Programs collaborate to promote use of
state tobacco quit lines State HDSP Program refers
managed care organizations to materials developed
by the Parks and Recreation Department and
Physical Activity Program on safe places to exercise
National HDSP Program Logic Model
State HDSP and WISEWOMAN Programs collaborate
to create systems for educating health care providers
on guidelines focused on risk factor prevention)
2 Enhance inclusion of key messages in the work
of related programs (eg State HDSP Program
works to implement JNC7 guidelines which
include referral to nutrition counseling the
WISEWOMAN Program incorporates education on
signs and symptoms of heart disease and stroke
into ongoing activities the State HDSP Program
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and system change supports
Level bull State bull Local
Settings bull Community bull Health care bull Worksite
Context bull Priority
Populations bull General
populations
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective intervention
implemented focused on
settings and Priority Populations
Change agents
take action
Activate intended audiences
Capa
city B
uildin
gSu
rveil
lance
Inter
vent
ions
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
21
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
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23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
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25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
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26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
DHDSP Organizational Structure
Office of the Director
Deputy Director Administrative Office
Associate Director for Science
Strategic Planning Partnerships and External Relations
Global Health Coordinator
Epidemiology and Surveillance Branch
Program Development and Services Branch
WISEWOMAN Team
Senior Advisor to Division Director
Applied Research and Evaluation Branch
Planning Partnerships and Policy Team
Health Communication and Program Information Team
Statistical Unit
Epidemiology and Surveillance Team
Small Area Analysis Team
Health Services Research and Registries Team
Program Services Team Applied Research and Translation Team
Evaluation and Program Effectiveness Team
4
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
5
provides grantees with comprehensive technical
assistance training and programmatic tools and
guidance for the development implementation
and evaluation of programs Together with related
programs across NCCDPHP PDSB provides
leadership to ensure collaboration that can affect
heart disease and stroke prevention outcomes
epidemiology and surveillance Branch ESB studies patterns and trends in the following areas
as they relate to cardiovascular diseases risk factors
costs health behaviors and outcomes barriers to
patient access to care public awareness geographic
variation and disparity of cardiovascular disease
rates among races and ethnic groups These scientific
findings allow DHDSP and its partners to respond
to emerging health risks and promote public health
practice ESB funds and manages the Paul Coverdell
National Acute Stroke Registry Staff provide technical
assistance and expertise through scientific articles
research findings geographic information system
mapping and promotion of new surveillance
methods and technologies
applied research and evaluation Branch AREB works with states partners and colleagues to
conduct and translate applied research and evaluation
of heart disease and stroke prevention efforts It
evaluates programs policies and interventions to
ensure they are working as planned and producing
the intended results It promotes evidence-based
practice by translating scientific findings into practical
resources and tools for public health practitioners
health care providers and others working to prevent
heart disease and stroke In addition AREB supports
state program activities through technical assistance
guidance resource development and capacity
building for applied research and evaluation
Funded Programs DHDSP funds and supports three national heart
disease and stroke prevention programs The fiscal
year 2010 appropriation was $56 million for heart
disease and stroke prevention programs Funds
are awarded through a competitive process for
the National Heart Disease and Stroke Prevention
Program Paul Coverdell National Acute Stroke
Registry and Sodium Reduction in Communities
Program
National Heart Disease and Stroke Prevention Program
The National Heart Disease and Stroke Prevention
Program provides funding and support to state
health departments to manage heart disease and
stroke prevention programs at the state and local
levels DHDSP shares the latest science and practices
with states to help reduce disease deaths and
health disparities related to heart disease and stroke
especially among those at high risk The program
has grown from funding 8 states in 1998 to funding
41 states and the District of Columbia in the current
funding cycle Twenty-eight states are funded for
capacity building and 14 for basic implementation
CDC-funded state programs promote changes to
policies and systems in health care worksite and
community settings and the elimination of health
disparities by emphasizing the ABCS of heart
disease and stroke prevention Some programs also
work to improve emergency response and quality
of acute care
WISEWOMAN
The Well-Integrated Screening and Evaluation for
WOMen Across the Nation (WISEWOMAN) Program
helps women with little or no health insurance
access services that can help reduce their risk for
heart disease stroke and other chronic diseases
The priority age group is women aged 40ndash64 years
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
6
2010 Funded Programs
2011 Funded Programs
NHDSP Funded States
WISEWOMAN Programs
WA
MT
ID WY
NV
AK
HI
AZ NM
TX
KSCO
OK
SD
ND
AR
IN OH
KY
TN
LA ALMS
FL
GA
NY
ME
OR
UT
CA
NE IA
MO
WI
IL
MN
MI
VAWV
SC
NC
PA NH
DE
VT
MD
NJ
RI
DC
MA
CT
Coverdell Stroke Registry States
Sodium Reduction Communities
Unfunded States
Note WISEWOMAN funds two tribal organizations in Alaska but not the state health department
Congress authorized the program in 1993 as an
expansion of services offered through the National
Breast and Cervical Cancer Early Detection Program
DHDSP funds WISEWOMAN programs in 19 states
and 2 tribal organizations Working in local clinics
and health care settings WISEWOMAN provides
heart disease and stroke risk factor screenings and
offers lifestyle interventions to help women increase
their physical activity improve their diet and engage
in tobacco cessation efforts
Paul Coverdell National Acute Stroke Registry
DHDSP funds states to establish surveillance systems
that measure track and provide data to help improve
the delivery and quality of stroke care among acute
stroke patients In 2001 Congress funded CDC to
establish the Paul Coverdell National Acute Stroke
Registry after US Senator Paul Coverdell of Georgia
suffered a fatal stroke while serving in Congress
The goal of the Coverdell Registry is to ensure that
all stroke patients receive the highest quality acute
stroke care available to reduce untimely deaths
prevent disability and avoid recurrent strokes With
Coverdell Registry data states and their health care
partners identify and analyze gaps in stroke care
systems and plan targeted strategies to address
them In June 2004 CDC funded four state health
departments (Georgia Illinois Massachusetts
and North Carolina) to establish Paul Coverdell
National Acute Stroke Registries In the most recent
Paul Coverdell National Acute Stroke Registry
funding cycle (2007ndash2011) CDC funded state health
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
7
departments in Georgia Massachusetts Michigan
Minnesota Ohio and North Carolina In 2007
CDC The Joint Commissionrsquos Primary Stroke Center
Certification program and the American Heart
AssociationAmerican Stroke Associationrsquos Get With
The Guidelinesreg-Stroke program jointly released a set
of standardized stroke performance measures to be
used by all three programs This effort has reduced
duplication of effort increased collaboration and
encouraged hospitals to participate in the programs
Office of the Director
Mississippi Delta Health Collaborative (Delta Health Initiative)
The Mississippi Delta Health Collaborative (MDHC)
is designed to prevent heart disease stroke and
related chronic diseases Through a new five-year
cooperative agreement this initiative will intensify
collaboration among the Mississippi Department of
Health existing chronic disease programs (eg heart
disease and stroke prevention diabetes tobacco
nutrition physical activity) local health departments
other community health care providers (eg
federally qualified health centers) local communities
and CDC This result will be achieved through
implementation of interventions across Mississippirsquos
18-county Delta Region The program will target
the ldquoABCSrdquo of heart disease and stroke prevention
among priority populations in high burden
underserved rural areas
bull Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
bull Hemoglobin A1c (HbA1c) Monitor and control
blood glucose
bull Blood pressure Prevent and control high blood
pressure
bull Cholesterol Prevent and control high LDL-
cholesterol
bull Smoking Prevent initiation and increase cessation
of smoking and increase the percentage of the
population protected by smoke-free air laws or
regulations
The Mississippi Department of Health will provide
leadership and funding support in the Delta
Region to implement prioritized population-based
interventions policy systems and environmental
change selected as appropriate from a set of
prescribed evidence-based strategies in both the
clinical and community settings
WISEWOMAN
The WISEWOMAN Program began a new five-
year funding cycle June 30 2008 The competitive
application process resulted in 21 programs being
funded This is an increase of six programs from the
previous funding cycle Seventeen WISEWOMAN
programs also receive funding to implement the
National Heart Disease and Stroke Prevention
Program
One major focus of the funding opportunity
announcement (FOA) is development of partnerships
At a minimum funded programs are expected to
partner with their statetribal Breast and Cervical
Cancer Early Detection Program Tobacco Control
Program Heart Disease and Stroke Prevention
ProgramCoalition and other programs that
can affect policies and environments in which
WISEWOMAN participants live work and play
Because the majority of WISEWOMAN funding must
be spent on providing direct services to women
partnerships are extremely important to ensure
participant access to affordable and quality resources
to support heart health
WISEWOMAN evaluation emphasizes program
improvement and is based on the CDC Framework
for Program Evaluation in Public Health CDC has
developed key evaluation questions related to the
programrsquos stated goals and logic model components
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
8
The questions are used in the evaluation of the
WISEWOMAN Program Funded programs are
required to conduct evaluations to assess progress
toward meeting stated work plan objectives and to
share results with others including their providers
partners other stakeholders and CDC Funded
programs contribute to the WISEWOMAN Program
evaluation by providing Minimum Data Elements
data submitting information to CDC that supports
program evaluation activities and participating in
activities such as site visits and case studies
Sodium Reduction in Communities
High sodium consumption is a major contributor
to high blood pressure a leading cause of stroke
coronary heart disease heart attack and heart and
kidney failure in the United States The 2010 Dietary
Guidelines for Americans recommend limiting
sodium to less than 2300 milligrams (mg) per day
Individuals who are 51 and older and those of any
age who are African American or have hypertension
diabetes or chronic kidney disease should limit
intake to 1500 mg of sodium per day These groups
account for about half the US population and the
majority of adults
Studies show that on average US adults consume
more than 3400 mg of sodium per day An estimated
77 percent of sodium comes from processed and
restaurant foods Reducing dietary intake of sodium
to 2300 mg per day could prevent as many as 11
million cases of hypertension in the United States
Further reductions in sodium intake to 1500 mg per
day could prevent more than 16 million cases
Through the three-year Sodium Reduction in
Communities cooperative agreement which began in
September 2010 DHDSP is providing support to six
communities to support policy changes designed to
create healthier food environments The communities
receiving support include California (Shasta County)
Kansas (Shawnee County) Los Angeles County
New York City and New York State (Broome and
Schenectady counties)
Program Development and Services Branch
Funded State Programs
National Heart Disease and Stroke Prevention Program The enhanced reach of the National
Heart Disease and Stroke Prevention Program was
a key accomplishment in 2008 Eight new states
(Connecticut Hawaii Idaho Iowa Maryland New
Jersey North Dakota and West Virginia) were funded
as part of the program bringing the total number of
funded programs to 42
Leadership to Center Integration PDSB has
provided leadership to NCCDPHPrsquos initiative to
increase synergy reach and desired health outcomes
in selected NCCDPHP-funded categorical programs
(National Heart Disease and Stroke Prevention
Diabetes Prevention and Control Tobacco Control
Comprehensive Cancer Control Nutrition Physical
Activity and Obesity and the Behavioral Risk Factor
Surveillance System)
National Training DHDSP conducted the 2008
National Heart Disease and Stroke Prevention
Training Institute on September 9ndash11 in Atlanta The
training focused on longer skill-building interactive
workshops that addressed the competencies
program priorities and performance measures of
the FOAs for DHDSPrsquos funded programs It included
the National Heart Disease and Stroke Prevention
Program and WISEWOMAN and was expanded to
include representation from each statersquos heart disease
program as well as American Heart Association
field staff working in the states Informal feedback
indicates that the training has already led to greater
collaboration at the state level
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
9
Management Information System (MIS) In 2008
DHDSP completed revisions for the heart disease
and stroke prevention Web-based MIS The report
generated by the system was changed to a table that
displays an objective time frame status and progress
in an easy-to-read format These changes made the
system more user friendly for states and CDC The
MIS can now be used to
bull Describe state program activities and expected
use of CDC funds
bull Track progress on state program activities and
identify promising practices
bull Assist CDC in identifying the need for training
and technical assistance
bull Standardize the state reporting process to
facilitate evaluation
bull Enable CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Funded Partnerships
Directors of Health Promotion and Education
(DHPE) In 2008 DHDSP continued to support
the DHPECDC Internship Program for Students
of Minority Serving Institutions
National Stroke Association DHDSP assisted with
funding for the Sixth Annual National Public Health
Stroke Summit conducted by the National Stroke
Association in Denver Colorado in December 2007
The Summit brought together 105 state public health
and health care professionals to promote information
sharing knowledge and skill building networking
and partnership development
National Collaborations
Cardiovascular Health (CVH) Council of the National Association of Chronic Disease Directors (NACDD) In 2008 the CVH Council
updated its section of the NACDD website to include
additional materials useful to states and it started
a Web discussion forum that allows states to share
ideas and products The Council obtained private
funds and sponsored the 2-day Northeast Regional
Workshop on Cholesterol Control in which 11
states participated in May 2008 It also funded two
of the participating states (Maine and Maryland)
to do follow-up work on cholesterol control with
their primary care associations and local federally
qualified health centers In March 2008 the
Council led the development of a themed issue of
the e-journal Preventing Chronic Disease In most
cases state program staff coauthored articles with
DHDSP staff The CVH Council worked with DHDSP
to assess the training needs of state programs in
the National Heart Disease and Stroke Prevention
Program and DHDSP used this information to plan
its September 2008 3-day training workshop for state
program and WISEWOMAN staff
Epidemiology and Surveillance Branch
Cardiac Arrest Registry to Enhance Survival
The Cardiac Arrest Registry to Enhance Survival
(CARES) began in 2005 in Atlanta and has since
expanded to 40 communities in 23 states CARES is
a simple but robust registry of cardiac arrest events
that allows participating sites to enter data related
to out-of-hospital cardiac arrest (OHCA) generate
summary reports and compare local data with
similar EMS systems elsewhere Three sources of
data are linked to describe each OHCA event 1)
9-1-1 call center data (to provide incident address
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
10
and dispatch and arrival times) 2) EMS data (to
describe initially recorded cardiac rhythm and
treatment methods) and 3) hospital data (emergency
department and hospital outcome hypothermia
treatment and neurologic status at discharge)
Multiple reporting features can be generated and
monitored continuously through secure online access
by CARES participants which allows for longitudinal
internal benchmarking Local EMS administrators
and medical directors are able to identify when and
where cardiac arrests occur which elements of their
EMS system are functioning properly in dealing
with these cases and what changes can be made to
improve outcomes In 2011 CARES began expanding
to statewide participation in six states which will
allow additional communities of different sizes and
population densities to be included in the registry In
addition state-level participation will promote better
communication and collaboration between state and
local EMS providers A recent MMWR Surveillance
Summary was published summarizing CARES data
collected during October 1 2005ndashDecember 31
2010 (wwwcdcgovmmwrpdfssss6008pdf) More
information about CARES can be found on the
CARES website at httpsmycaresnet
Paul Coverdell National Acute Stroke Registry
New Registries The Paul Coverdell National
Acute Stroke Registry program successfully
implemented stroke registries in three newly
funded states in 2007 (Michigan Minnesota and
Ohio) These states made much greater progress
in their first year toward developing program
infrastructure collecting data and engaging in
quality improvement activities than had the four
states that completed their first year of Coverdell
Registry funding in 2004 Much of this progress can
be attributed to CDCrsquos increased capacity to provide
proactive technical assistance to states through
conference calls work groups and resource
materials such as the program resource manual
Supplemental Projects The Coverdell Registry
team developed and funded a supplemental
cooperative agreement to pilot the expansion of
the Coverdell Registry model to other domains
within stroke systems of care North Carolina was
funded to demonstrate the feasibility of linking
pre-hospital EMS data for stroke with the state
Coverdell Registry (the North Carolina Stroke
Care Collaborative) In 2010 in partnership with
the Association of State and Territorial Health
Officials CDC funded two Coverdell states to
develop comprehensive statewide stroke care
systems plans CDC is currently funding the Ohio
Coverdell Registry to study 30-day outcomes
of stroke patients based on the quality of care
provided In partnership with the Agency for
Healthcare Research and Quality CDC has funded
an evidence-based review of transitions in care
from hospital to home or rehabilitation for stroke
patients
National Evaluation Plan Through a yearlong
collaboration with RTI International the Coverdell
Registry developed a national evaluation plan The
plan provides a systematic method of assessing
the annual and long-term performance of the
program including strategic goals and objectives
performance goals performance measures and
targets for program outcomes
Consensus Stroke Performance Measures
Endorsement of the Consensus Stroke
Performance Measures The Coverdell Registry
partnered with the American Heart Association
and The Joint Commission to develop performance
measures for acute stroke care commonly
referred to as the Consensus Stroke Performance
Measures These measures were released to
hospitals throughout the United States in fall
2007 In January 2008 more than 1200 hospitals
began using these measures to improve the quality
of care for acute stroke patients The measures
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11
were submitted to the National Quality Forum in
March 2008 and 8 of the 10 were adopted This
endorsement of the Consensus Stroke Performance
Measures has paved the way for adoption of
these measures by the Centers for Medicare
and Medicaid Services for quality reporting and
meaningful use
Quarterly Data Reports With the implementation
of the Consensus Stroke Performance Measures in
January 2008 CDC began providing states with
quarterly data reports on the measures These
reports provide each state with a summary of its
data on ischemic stroke hemorrhagic stroke and
transient ischemic attacks as well as aggregate data
for all states in the Coverdell Registry program
Applied Research and Evaluation Branch
Building an Economic Evaluation Research Agenda
Based on program needs and research gaps in heart
disease and stroke prevention the Applied Research
and Evaluation Branch developed an agenda to
guide economic research on 1) economic burden
of cardiovascular diseases and cost-effectiveness of
their control 2) economic value of DHDSP-funded
and other state prevention programs 3) CDCrsquos
Internet-based clearinghouse for information on
the economics of cardiovascular diseases and 4)
developing partnerships in economic research to
increase the impact of such research
Stroke Awareness Signs and Symptoms Awareness Campaigns
To provide guidance for state programs a review of
current research on stroke awareness campaigns was
undertaken to identify evidence to support the most
appropriate ways to increase knowledge of signs and
symptoms for stroke the importance of calling 9-1-1
and relationships between the educational campaigns
and outcomes related to awareness of stroke signs
and symptoms
The literature review and synthesis of current
research on stroke awareness campaigns resulted
in the following dissemination activities
bull Development of a fact sheet for state programs on
literature review findings and considerations for
statesrsquo current activities related to stroke awareness
messages including direct education and tools
available to facilitate campaign development
bull Poster presentation at the 2008 National
Conference on Health Communication Marketing
and Media on evaluation guidance for stroke
awareness campaigns The presentation outlined
specific information for states and communities on
how to strengthen the effectiveness and outcome
evaluation of their stroke awareness campaigns
bull Presentation at the 2008 National Heart Disease
and Stroke Prevention Training Institute about
evidence and research on communication and
media campaigns impact considerations of cost
opportunities for partnering and evaluating
results
Comprehensive and Core Indicators
DHDSP released a set of core indicators for
hypertension as part of a comprehensive evidence-
based set of indicators to guide state heart disease
and stroke prevention programs in evaluating their
efforts State health departments received related
key guidance documents training at the National
Heart Disease and Stroke Prevention Training
Institute and a series of follow-up trainings
Indicators are presented in a Consumer Reports
format and rated on multiple dimensions such as
strength of scientific evidence feasibility of data
collection and face validity
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
12
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkitmdash Evaluation Results
CDC worked with the American Institutes for
Research (AIR) to conduct an evaluation of the
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit State health departments
(SHDs) were trained to use the toolkit to promote
state employer-based initiatives on workplace efforts
for heart disease and stroke prevention
From 2005 to 2007 all the SHDs received copies of
the toolkit and were invited to attend training sessions
(one seminar five webinars and three consultations)
To evaluate the usefulness of the toolkit materials
and obtain recommendations two focus groups with
business leaders and Web-based surveys of the SHDs
were conducted In 2006 all 50 states and the District
of Columbia completed the baseline and in 2008 40
states completed the follow-up
Of the 40 SHDs that completed both waves of the
survey the proportion that reported engaging in
employer-based initiatives significantly increased
from 65 percent to 725 percent during the period
examined despite a reported reduction in staff and
limited appropriations About 90 percent of the
SHDs that responded to the 2008 survey are now
working with employers to promote comprehensive
heart disease and stroke prevention programs
disseminate best practices establish employer-
oriented partnerships participate in seminars for
employers and provide business leaders with
resources Partnerships with employer groups or
business coalitions have focused on worksite policy
changes health promotion and education and
worksite surveillance and assessments In parallel
to these experiences the SHDs have increased their
overall level of confidence in their knowledge and
skills Most of the SHDs (61 percent) agreed that
the CDC trainings and consultations helped them
improve their heart disease and stroke prevention
programs and use the toolkit more effectively
Participation in the trainings was positively associated
with engagement in worksite health promotion and
education The SHDs that received federal funding
had significantly higher participation in macro-
marketing activities reaching employers through
business coalitions associations task forces and
champions and were more likely to establish
partnerships with employer groups and government
agencies
The Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit is available at wwwcdc
govdhdsplibrarytoolkitindexhtm
The Branch also provides economics support to
the Division and partners by documenting costs of
cardiovascular diseases and their risk factors and
identifying cost-effective interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
13
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
National Heart Disease and Stroke Prevention Program Overview
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
14
u Blood pressure Prevent and control high blood Program Overview pressure reduce sodium intake
bull In 1998 the US Congress provided funding
for CDC to initiate a national state-based Heart
Disease and Stroke Prevention (HDSP) program in
eight states
bull CDC funds programs in 41 states and the
District of Columbia Twenty-eight are capacity
building (planning) programs and 14 are basic
implementation (intervention) programs
bull Capacity Building Programs Alabama
Alaska Arizona California Colorado Connecticut
District of Columbia Hawaii Idaho Illinois Iowa
Kansas Kentucky Louisiana Maryland Michigan
Minnesota Mississippi Nebraska New Jersey
North Dakota Ohio Oklahoma Oregon Rhode
Island Tennessee Texas and Wisconsin
bull Basic Implementation Programs Arkansas
Florida Georgia Maine Massachusetts Missouri
Montana New York North Carolina South
Carolina Utah Virginia Washington and West
Virginia
National Heart Disease and Stroke Prevention Program Goals bull Enhance state capacity to plan implement track
and sustain population-based interventions to
address heart disease stroke and related risk
factors Focus program efforts on population-
based policy and systems change strategies to
impact the ldquoABCSrdquo of heart disease and stroke
prevention
u Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
u Cholesterol Prevent and control high
cholesterol
u Smoking Increase the number of smokers
counseled to quit and referred to quitlines by
health care workers increase availability of no
or low-cost cessation products and collaborate
with efforts to increase the percentage of the
population protected by smoke-free air laws
and regulations
To a lesser extent state HDSP programs work to
improve emergency response and quality of acute
care systems
State HDSP programs work to eliminate health
disparities in priority populations (ie groups with
increased burden or need based on race ethnicity
gender geography or socioeconomic status) as an
overarching principle
bull Collaborate with chronic disease programs (eg
those focusing on tobacco diabetes physical
inactivity poor nutrition and obesityoverweight)
and partners to develop and integrate population-
based strategies to prevent heart disease and
stroke
bull Promote cardiovascular health in health care
worksite and community settings through policy
and systems changes
bull Identify and evaluate promising practices to
address heart disease and stroke
bull Conduct surveillance of heart disease stroke
and related risk factors
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
15
u
u
Key Responsibilities of State Capacity Building Programs bull Facilitate collaboration with public- and private-
sector partners such as not-for-profit health
agencies health systems organizations emergency
response agencies federally funded health centers
businesses priority population organizations and
voluntary health organizations
bull Document the state burden of heart disease
stroke and related risk factors
bull Develop plans for population-based strategies
for preventing heart disease and stroke among
general and Priority Populations
bull Develop a comprehensive state HDSP plan
bull Develop an HDSP program logic model and
evaluation plan
bull Assess assets and gaps in state policy and systems
related to HDSP in health care worksite and
community settings
Key Responsibilities of State Basic Implementation Programs bull Enhance all capacity-building program activities
bull Implement and evaluate policy systems change
and educational interventions that address the
six HDSP program priority areas in health care
worksite and community settings
bull Provide training and technical assistance to
public health and health care professionals and
partners to support policy and system changes
that will encourage heart disease and stroke
prevention
How CDC Assists State Heart Disease and Stroke Prevention Programs bull Provides training technical assistance and
funding
bull Funds applied research on heart disease and
stroke interventions and elimination of disparities
that is relevant to state programs
bull Identifies and disseminates science-based
promising practices
bull Partners with national organizations to help states
address prevention of heart disease and stroke
bull Facilitates collaborations with other state chronic
disease programs or activities that address risk
factors populations or settings related to heart
disease and stroke prevention and program
priority areas
bull Develops and disseminates publications and tools
such as
u CDCynergy a CD-ROM-based tool for
planning health communication interventions
State Heart Disease and Stroke Prevention
Program Evaluation Framework (wwwcdc
govdhdsplibraryevaluation_framework
indexhtm) a document providing guidance
on systematic ways to measure the success of
public health programs and on logic model
development
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping an
Evaluation Plan (wwwcdcgovDHDSPstate_
programevaluation_guidesevaluation_plan
htm) a document providing guidance on the
development of evaluation activities to help
programs identify required staff time and
resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
16
u
u
u
u
u
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping and
Using a Logic Model (wwwcdcgovDHDSP
state_programevaluation_guideslogic_model
htm) a document providing guidance on
the development and use of logic models as
planning and evaluation tools
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashWriting SMART
Objectives (wwwcdcgovDHDSPstate_
programevaluation_guidessmart_objectives
htm) a document providing guidance to
states on the development of realistic and
measurable objectives
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit (wwwcdcgov
dhdsplibrarytoolkitindexhtm) a document
that provides information materials and
tools that state programs can reference and
distribute to businesses primarily through
employer and professional organizations
Heart Disease and Stroke Interactive Maps
(wwwcdcgovdhdsplibrarymapsstatemaps
htm) which present heart disease and stroke
mortality rates by county for the state racial
ethnic group and gender of the userrsquos choice
A Communication Guide for Policy and
Environmental Change (wwwcdcgovdhdsp
libraryheart_stroke_guideindexhtm) which
includes information references and examples
of communication from state programs and
Stroke Addendum to the Communication
Guide (wwwcdcgovdhdsplibraryheart_
stroke_guideindexhtm)
For additional information please visit the CDC
website at wwwcdcgovdhdsp or contact the
Division for Heart Disease and Stroke Prevention
Program Development and Services Branch at
(770) 488-2424
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17
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
State Heart Disease and Stroke Prevention Program Funding Opportunity Announcement DP07-704 At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
18
Introduction The Funding Opportunity Announcement
(FOA) DP07-704 At-A-Glance provides important
information to assist programs funded under this
announcement to deliver their program as intended
The At-A-Glance highlights aspects of FOA DP07-704
important for all funded programs including
the following
bull Overview of the National Heart Disease and
Stroke Prevention Program
bull Heart Disease and Stroke Prevention State
Program roles
bull Performance measures for Capacity Building Basic
Implementation Optional Funding for Capacity
Building programs and Stroke Networks
bull Funded program reporting requirements
bull Budgetfunding guidance
bull National and administrative policy requirements
If a program needs a copy of the full document
it should contact its project officer (see Program
Contacts section of the full National Heart Disease
and Stroke Prevention Program Staff Orientation
Manual) to fulfill that request
Section 1 Background In 1998 the US Congress provided funding for
CDC to initiate a national state-based cardiovascular
health program The Senate Appropriations
Committee in 2005 encouraged CDC to create the
Division for Heart Disease and Stroke Prevention and
increased resources enabling CDC to reach 32 of the
50 states and the District of Columbia with funding
for heart disease and stroke prevention As of 2008
the Heart Disease and Stroke Prevention (HDSP)
program funds 41 states and the District of Columbia
As the Division for Heart Disease and Stroke
Prevention developed so did the focus of the State
HDSP Program Focusing on the six program priority
areas (noted below) should impact morbidity and
mortality of these diseases State programs should
increase heart disease and stroke prevention policies
and systems change with the potential to impact
the general population and Priority Populations
(see Prevention Works CDC Strategies for a Heart-
healthy and Stroke-free America wwwCDCgov
dhdsplibrary) For more information on the CDC
State HDSP Program visit wwwcdcgovdhdspState_
programindexhtm
A Public Health Action Plan to Prevent Heart Disease
and Stroke (see wwwCDCgovdhdsplibrary)
documents the multiple intervention opportunities
for preventing heart disease and stroke It is
important to work with partners collaboratively in
leveraging resources to address the multiple risk
factors that are associated with these diseases
Announcement DP07-704 supports program
components considered essential to enhancing
the leadership of state health departments in
heart disease and stroke prevention It provides
for the funding of capacity building and basic
implementation programs as well as projects such as
the Optional Funding for Capacity Building Programs
and Stroke Networks
A capacity building program develops the foundation
for a comprehensive cardiovascular disease prevention
program through such activities as partnership
development definition of the burden and
development of a state plan A basic implementation
program enhances capacity building activities and
implements disseminates and evaluates intervention
activities that address the state plan objectives and the
CDC program priority areas 1ndash6
1 Increase control of high blood pressure primarily
in adults and older adults
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19
2 Increase control of high blood cholesterol
primarily in adults and older adults
3 Increase knowledge of signs and symptoms for
heart attack and stroke and the importance of
calling 9-1-1
4 Improve emergency response
5 Improve quality of heart disease and stroke care
6 Eliminate disparities in terms of race ethnicity
gender geography or socioeconomic status
Optional Funding for Capacity Building Programs
provides support to programs to implement an
evidence-based or promising practice demonstration
project that addresses the CDC program priority
areas 1ndash6
Stroke Networks support a state health department to
increase stroke prevention activities across a group of
three to six contiguous member states with emphasis
on increasing awareness and implementing priority
policy or systems changes across the states
The State HDSP Program is anchored on the
framework of the Socio-ecological Model which
conceptualized the influences of individual
behaviors family and social relationships community
and environmental effects and societal influences
such as policies on health status In order to
promote significant impact for improving the health
of the population interventions should focus on
implementing policy and systems change strategies
that support heart disease and stroke prevention
Policy change can be addressed through a) public
policy (eg establishing certification for hospital-
based stroke centers) or b) organizational policy
(eg businesses providing health benefits plans
that cover preventive services that include blood
pressure control)
System changes are encouraged in three settings
worksites health care and communities An
example of a systems change is when a health
care setting implements electronic records and
patient care management systems that improve the
quality of health care Interventions within systems
are encouraged at the highest level possiblemdashfor
example activities with business coalitions rather
than individual worksites and with managed care
organizations (MCOs) and state medical associations
rather than individual health care sites or physicians
By working at higher levels to affect systems change
states can impact larger segments of the population
Education and awareness efforts to enhance
public understanding and promote actions related
to cardiovascular diseases and the risk factors of
high blood pressure and high cholesterol signs
and symptoms of heart attack and stroke and the
need to call 9-1-1 are also components of capacity
enhancement
An overarching goal of the State HDSP Program
is to address disparities in heart disease and
stroke and the related risk factors using policy and
systems change strategies Based on disparities
(eg raceethnicity gender geographic geography
socioeconomic status) in mortality access to care
or burden of risk factors the State HDSP Program
should identify Priority Populations and implement
interventions to reach those Priority Populations
No one organization will be able to address the
prevention of heart disease and stroke It will require
many organizations working in collaboration if
progress is to be made in accomplishing the Healthy
People 2010 Objectives Collaboration is defined
by the Wilder Foundation as ldquoa mutually beneficial
and well-defined relationship entered into by two
or more organizations to achieve common goals
The relationship includes a commitment to mutual
relationships and goals a jointly developed structure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
20
and shared responsibility mutual authority and
accountability for success and sharing of resources
and rewardsrdquo Developing and maintaining
strategic partnerships are key to the leveraging of
skills and resources to prevent heart disease and
stroke in a comprehensive way The State HDSP
Program has two major roles related to partners
The first is to convene or facilitate collaboration
to develop and implement a comprehensive state
plan and intervention implementation strategies
that addresses heart disease stroke and related
risk factors The second is to develop strategies to
leverage resources and coordinate interventions
with partners that address the six program
priority areas
A logic model has been developed to describe
the State HDSP Program as intended by the CDC
funding to state health departments (see following
page) The model depicts relationships and actions
(eg links between environment and policy
change and individual-level behavioral change)
that are expected to culminate in reduction in
heart disease and stroke
The CDC and state activities are outlined in terms
of capacity building surveillancemonitoring
and interventions Both CDC and state activities
influence changes that lead to short-term
outcomes such as development of a work plan
and strategies for system-level changes effective
implementation of interventions and action by
target audiences and change agents (those who are
in the position to influence policies and systems
such as hospital administrators and MCO decision
makers) These activities and outcomes result in
changes in policy and environmental supports
which in turn influence behavior changes and
improve health status Ultimately these changes
decrease premature death and disability and
eliminate cardiovascular disparities between
general and Priority Populations
The State HDSP logic model also is a tool to guide
program evaluation By identifying the steps
necessary to reach intended outcomes the logic
model provides guidance in evaluating the short and
intermediate outcomes of the program
State evaluation efforts should relate to the National
HDSP Program logic model or to a logic model that
the state develops that complements the national
model and the required program recipient activities
The logic model can also be seen in the CDC
Evaluation Framework for Heart Disease and Stroke
Prevention State Programs at wwwcdcgovdhdsp
Section 2 National Heart Disease and Stroke Prevention State Program Roles In A Public Health Action Plan to Prevent Heart
Disease and Stroke there are four major goals which
are based on Healthy People 2010
Goal 1 Prevention of risk factors
Goal 2 Detection and treatment of risk factors
Goal 3 Early identification and treatment of heart
attacks and strokes
Goal 4 Prevention of recurrent cardiovascular events
CDC-funded State HDSP Programs have a direct
impact on Goals 2 3 and 4 by addressing HDSP
program priority areas 1ndash6 (see Background section)
HDSP programs have a supportive role with other
state health department programs and partners in
addressing Goal 1 Efforts to address Goal 1 related
to tobacco use diabetes obesity poor nutrition
physical inactivity and schools as a worksite should
be done through a supportive or collaborative role
with the state WISEWOMAN diabetes tobacco
nutrition physical activity or coordinated school
health programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
bull State HDSP Programs are encouraged to
coordinate with other programs in ways that
1 Address Goal 1 (eg State HDSP and Nutrition
Programs identify primary prevention messages
related to cholesterol and salt to be included in Nushy
trition Programs where appropriate State HDSP and
Tobacco Programs collaborate to promote use of
state tobacco quit lines State HDSP Program refers
managed care organizations to materials developed
by the Parks and Recreation Department and
Physical Activity Program on safe places to exercise
National HDSP Program Logic Model
State HDSP and WISEWOMAN Programs collaborate
to create systems for educating health care providers
on guidelines focused on risk factor prevention)
2 Enhance inclusion of key messages in the work
of related programs (eg State HDSP Program
works to implement JNC7 guidelines which
include referral to nutrition counseling the
WISEWOMAN Program incorporates education on
signs and symptoms of heart disease and stroke
into ongoing activities the State HDSP Program
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and system change supports
Level bull State bull Local
Settings bull Community bull Health care bull Worksite
Context bull Priority
Populations bull General
populations
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective intervention
implemented focused on
settings and Priority Populations
Change agents
take action
Activate intended audiences
Capa
city B
uildin
gSu
rveil
lance
Inter
vent
ions
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
21
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
5
provides grantees with comprehensive technical
assistance training and programmatic tools and
guidance for the development implementation
and evaluation of programs Together with related
programs across NCCDPHP PDSB provides
leadership to ensure collaboration that can affect
heart disease and stroke prevention outcomes
epidemiology and surveillance Branch ESB studies patterns and trends in the following areas
as they relate to cardiovascular diseases risk factors
costs health behaviors and outcomes barriers to
patient access to care public awareness geographic
variation and disparity of cardiovascular disease
rates among races and ethnic groups These scientific
findings allow DHDSP and its partners to respond
to emerging health risks and promote public health
practice ESB funds and manages the Paul Coverdell
National Acute Stroke Registry Staff provide technical
assistance and expertise through scientific articles
research findings geographic information system
mapping and promotion of new surveillance
methods and technologies
applied research and evaluation Branch AREB works with states partners and colleagues to
conduct and translate applied research and evaluation
of heart disease and stroke prevention efforts It
evaluates programs policies and interventions to
ensure they are working as planned and producing
the intended results It promotes evidence-based
practice by translating scientific findings into practical
resources and tools for public health practitioners
health care providers and others working to prevent
heart disease and stroke In addition AREB supports
state program activities through technical assistance
guidance resource development and capacity
building for applied research and evaluation
Funded Programs DHDSP funds and supports three national heart
disease and stroke prevention programs The fiscal
year 2010 appropriation was $56 million for heart
disease and stroke prevention programs Funds
are awarded through a competitive process for
the National Heart Disease and Stroke Prevention
Program Paul Coverdell National Acute Stroke
Registry and Sodium Reduction in Communities
Program
National Heart Disease and Stroke Prevention Program
The National Heart Disease and Stroke Prevention
Program provides funding and support to state
health departments to manage heart disease and
stroke prevention programs at the state and local
levels DHDSP shares the latest science and practices
with states to help reduce disease deaths and
health disparities related to heart disease and stroke
especially among those at high risk The program
has grown from funding 8 states in 1998 to funding
41 states and the District of Columbia in the current
funding cycle Twenty-eight states are funded for
capacity building and 14 for basic implementation
CDC-funded state programs promote changes to
policies and systems in health care worksite and
community settings and the elimination of health
disparities by emphasizing the ABCS of heart
disease and stroke prevention Some programs also
work to improve emergency response and quality
of acute care
WISEWOMAN
The Well-Integrated Screening and Evaluation for
WOMen Across the Nation (WISEWOMAN) Program
helps women with little or no health insurance
access services that can help reduce their risk for
heart disease stroke and other chronic diseases
The priority age group is women aged 40ndash64 years
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
6
2010 Funded Programs
2011 Funded Programs
NHDSP Funded States
WISEWOMAN Programs
WA
MT
ID WY
NV
AK
HI
AZ NM
TX
KSCO
OK
SD
ND
AR
IN OH
KY
TN
LA ALMS
FL
GA
NY
ME
OR
UT
CA
NE IA
MO
WI
IL
MN
MI
VAWV
SC
NC
PA NH
DE
VT
MD
NJ
RI
DC
MA
CT
Coverdell Stroke Registry States
Sodium Reduction Communities
Unfunded States
Note WISEWOMAN funds two tribal organizations in Alaska but not the state health department
Congress authorized the program in 1993 as an
expansion of services offered through the National
Breast and Cervical Cancer Early Detection Program
DHDSP funds WISEWOMAN programs in 19 states
and 2 tribal organizations Working in local clinics
and health care settings WISEWOMAN provides
heart disease and stroke risk factor screenings and
offers lifestyle interventions to help women increase
their physical activity improve their diet and engage
in tobacco cessation efforts
Paul Coverdell National Acute Stroke Registry
DHDSP funds states to establish surveillance systems
that measure track and provide data to help improve
the delivery and quality of stroke care among acute
stroke patients In 2001 Congress funded CDC to
establish the Paul Coverdell National Acute Stroke
Registry after US Senator Paul Coverdell of Georgia
suffered a fatal stroke while serving in Congress
The goal of the Coverdell Registry is to ensure that
all stroke patients receive the highest quality acute
stroke care available to reduce untimely deaths
prevent disability and avoid recurrent strokes With
Coverdell Registry data states and their health care
partners identify and analyze gaps in stroke care
systems and plan targeted strategies to address
them In June 2004 CDC funded four state health
departments (Georgia Illinois Massachusetts
and North Carolina) to establish Paul Coverdell
National Acute Stroke Registries In the most recent
Paul Coverdell National Acute Stroke Registry
funding cycle (2007ndash2011) CDC funded state health
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
7
departments in Georgia Massachusetts Michigan
Minnesota Ohio and North Carolina In 2007
CDC The Joint Commissionrsquos Primary Stroke Center
Certification program and the American Heart
AssociationAmerican Stroke Associationrsquos Get With
The Guidelinesreg-Stroke program jointly released a set
of standardized stroke performance measures to be
used by all three programs This effort has reduced
duplication of effort increased collaboration and
encouraged hospitals to participate in the programs
Office of the Director
Mississippi Delta Health Collaborative (Delta Health Initiative)
The Mississippi Delta Health Collaborative (MDHC)
is designed to prevent heart disease stroke and
related chronic diseases Through a new five-year
cooperative agreement this initiative will intensify
collaboration among the Mississippi Department of
Health existing chronic disease programs (eg heart
disease and stroke prevention diabetes tobacco
nutrition physical activity) local health departments
other community health care providers (eg
federally qualified health centers) local communities
and CDC This result will be achieved through
implementation of interventions across Mississippirsquos
18-county Delta Region The program will target
the ldquoABCSrdquo of heart disease and stroke prevention
among priority populations in high burden
underserved rural areas
bull Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
bull Hemoglobin A1c (HbA1c) Monitor and control
blood glucose
bull Blood pressure Prevent and control high blood
pressure
bull Cholesterol Prevent and control high LDL-
cholesterol
bull Smoking Prevent initiation and increase cessation
of smoking and increase the percentage of the
population protected by smoke-free air laws or
regulations
The Mississippi Department of Health will provide
leadership and funding support in the Delta
Region to implement prioritized population-based
interventions policy systems and environmental
change selected as appropriate from a set of
prescribed evidence-based strategies in both the
clinical and community settings
WISEWOMAN
The WISEWOMAN Program began a new five-
year funding cycle June 30 2008 The competitive
application process resulted in 21 programs being
funded This is an increase of six programs from the
previous funding cycle Seventeen WISEWOMAN
programs also receive funding to implement the
National Heart Disease and Stroke Prevention
Program
One major focus of the funding opportunity
announcement (FOA) is development of partnerships
At a minimum funded programs are expected to
partner with their statetribal Breast and Cervical
Cancer Early Detection Program Tobacco Control
Program Heart Disease and Stroke Prevention
ProgramCoalition and other programs that
can affect policies and environments in which
WISEWOMAN participants live work and play
Because the majority of WISEWOMAN funding must
be spent on providing direct services to women
partnerships are extremely important to ensure
participant access to affordable and quality resources
to support heart health
WISEWOMAN evaluation emphasizes program
improvement and is based on the CDC Framework
for Program Evaluation in Public Health CDC has
developed key evaluation questions related to the
programrsquos stated goals and logic model components
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
8
The questions are used in the evaluation of the
WISEWOMAN Program Funded programs are
required to conduct evaluations to assess progress
toward meeting stated work plan objectives and to
share results with others including their providers
partners other stakeholders and CDC Funded
programs contribute to the WISEWOMAN Program
evaluation by providing Minimum Data Elements
data submitting information to CDC that supports
program evaluation activities and participating in
activities such as site visits and case studies
Sodium Reduction in Communities
High sodium consumption is a major contributor
to high blood pressure a leading cause of stroke
coronary heart disease heart attack and heart and
kidney failure in the United States The 2010 Dietary
Guidelines for Americans recommend limiting
sodium to less than 2300 milligrams (mg) per day
Individuals who are 51 and older and those of any
age who are African American or have hypertension
diabetes or chronic kidney disease should limit
intake to 1500 mg of sodium per day These groups
account for about half the US population and the
majority of adults
Studies show that on average US adults consume
more than 3400 mg of sodium per day An estimated
77 percent of sodium comes from processed and
restaurant foods Reducing dietary intake of sodium
to 2300 mg per day could prevent as many as 11
million cases of hypertension in the United States
Further reductions in sodium intake to 1500 mg per
day could prevent more than 16 million cases
Through the three-year Sodium Reduction in
Communities cooperative agreement which began in
September 2010 DHDSP is providing support to six
communities to support policy changes designed to
create healthier food environments The communities
receiving support include California (Shasta County)
Kansas (Shawnee County) Los Angeles County
New York City and New York State (Broome and
Schenectady counties)
Program Development and Services Branch
Funded State Programs
National Heart Disease and Stroke Prevention Program The enhanced reach of the National
Heart Disease and Stroke Prevention Program was
a key accomplishment in 2008 Eight new states
(Connecticut Hawaii Idaho Iowa Maryland New
Jersey North Dakota and West Virginia) were funded
as part of the program bringing the total number of
funded programs to 42
Leadership to Center Integration PDSB has
provided leadership to NCCDPHPrsquos initiative to
increase synergy reach and desired health outcomes
in selected NCCDPHP-funded categorical programs
(National Heart Disease and Stroke Prevention
Diabetes Prevention and Control Tobacco Control
Comprehensive Cancer Control Nutrition Physical
Activity and Obesity and the Behavioral Risk Factor
Surveillance System)
National Training DHDSP conducted the 2008
National Heart Disease and Stroke Prevention
Training Institute on September 9ndash11 in Atlanta The
training focused on longer skill-building interactive
workshops that addressed the competencies
program priorities and performance measures of
the FOAs for DHDSPrsquos funded programs It included
the National Heart Disease and Stroke Prevention
Program and WISEWOMAN and was expanded to
include representation from each statersquos heart disease
program as well as American Heart Association
field staff working in the states Informal feedback
indicates that the training has already led to greater
collaboration at the state level
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
9
Management Information System (MIS) In 2008
DHDSP completed revisions for the heart disease
and stroke prevention Web-based MIS The report
generated by the system was changed to a table that
displays an objective time frame status and progress
in an easy-to-read format These changes made the
system more user friendly for states and CDC The
MIS can now be used to
bull Describe state program activities and expected
use of CDC funds
bull Track progress on state program activities and
identify promising practices
bull Assist CDC in identifying the need for training
and technical assistance
bull Standardize the state reporting process to
facilitate evaluation
bull Enable CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Funded Partnerships
Directors of Health Promotion and Education
(DHPE) In 2008 DHDSP continued to support
the DHPECDC Internship Program for Students
of Minority Serving Institutions
National Stroke Association DHDSP assisted with
funding for the Sixth Annual National Public Health
Stroke Summit conducted by the National Stroke
Association in Denver Colorado in December 2007
The Summit brought together 105 state public health
and health care professionals to promote information
sharing knowledge and skill building networking
and partnership development
National Collaborations
Cardiovascular Health (CVH) Council of the National Association of Chronic Disease Directors (NACDD) In 2008 the CVH Council
updated its section of the NACDD website to include
additional materials useful to states and it started
a Web discussion forum that allows states to share
ideas and products The Council obtained private
funds and sponsored the 2-day Northeast Regional
Workshop on Cholesterol Control in which 11
states participated in May 2008 It also funded two
of the participating states (Maine and Maryland)
to do follow-up work on cholesterol control with
their primary care associations and local federally
qualified health centers In March 2008 the
Council led the development of a themed issue of
the e-journal Preventing Chronic Disease In most
cases state program staff coauthored articles with
DHDSP staff The CVH Council worked with DHDSP
to assess the training needs of state programs in
the National Heart Disease and Stroke Prevention
Program and DHDSP used this information to plan
its September 2008 3-day training workshop for state
program and WISEWOMAN staff
Epidemiology and Surveillance Branch
Cardiac Arrest Registry to Enhance Survival
The Cardiac Arrest Registry to Enhance Survival
(CARES) began in 2005 in Atlanta and has since
expanded to 40 communities in 23 states CARES is
a simple but robust registry of cardiac arrest events
that allows participating sites to enter data related
to out-of-hospital cardiac arrest (OHCA) generate
summary reports and compare local data with
similar EMS systems elsewhere Three sources of
data are linked to describe each OHCA event 1)
9-1-1 call center data (to provide incident address
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
10
and dispatch and arrival times) 2) EMS data (to
describe initially recorded cardiac rhythm and
treatment methods) and 3) hospital data (emergency
department and hospital outcome hypothermia
treatment and neurologic status at discharge)
Multiple reporting features can be generated and
monitored continuously through secure online access
by CARES participants which allows for longitudinal
internal benchmarking Local EMS administrators
and medical directors are able to identify when and
where cardiac arrests occur which elements of their
EMS system are functioning properly in dealing
with these cases and what changes can be made to
improve outcomes In 2011 CARES began expanding
to statewide participation in six states which will
allow additional communities of different sizes and
population densities to be included in the registry In
addition state-level participation will promote better
communication and collaboration between state and
local EMS providers A recent MMWR Surveillance
Summary was published summarizing CARES data
collected during October 1 2005ndashDecember 31
2010 (wwwcdcgovmmwrpdfssss6008pdf) More
information about CARES can be found on the
CARES website at httpsmycaresnet
Paul Coverdell National Acute Stroke Registry
New Registries The Paul Coverdell National
Acute Stroke Registry program successfully
implemented stroke registries in three newly
funded states in 2007 (Michigan Minnesota and
Ohio) These states made much greater progress
in their first year toward developing program
infrastructure collecting data and engaging in
quality improvement activities than had the four
states that completed their first year of Coverdell
Registry funding in 2004 Much of this progress can
be attributed to CDCrsquos increased capacity to provide
proactive technical assistance to states through
conference calls work groups and resource
materials such as the program resource manual
Supplemental Projects The Coverdell Registry
team developed and funded a supplemental
cooperative agreement to pilot the expansion of
the Coverdell Registry model to other domains
within stroke systems of care North Carolina was
funded to demonstrate the feasibility of linking
pre-hospital EMS data for stroke with the state
Coverdell Registry (the North Carolina Stroke
Care Collaborative) In 2010 in partnership with
the Association of State and Territorial Health
Officials CDC funded two Coverdell states to
develop comprehensive statewide stroke care
systems plans CDC is currently funding the Ohio
Coverdell Registry to study 30-day outcomes
of stroke patients based on the quality of care
provided In partnership with the Agency for
Healthcare Research and Quality CDC has funded
an evidence-based review of transitions in care
from hospital to home or rehabilitation for stroke
patients
National Evaluation Plan Through a yearlong
collaboration with RTI International the Coverdell
Registry developed a national evaluation plan The
plan provides a systematic method of assessing
the annual and long-term performance of the
program including strategic goals and objectives
performance goals performance measures and
targets for program outcomes
Consensus Stroke Performance Measures
Endorsement of the Consensus Stroke
Performance Measures The Coverdell Registry
partnered with the American Heart Association
and The Joint Commission to develop performance
measures for acute stroke care commonly
referred to as the Consensus Stroke Performance
Measures These measures were released to
hospitals throughout the United States in fall
2007 In January 2008 more than 1200 hospitals
began using these measures to improve the quality
of care for acute stroke patients The measures
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
11
were submitted to the National Quality Forum in
March 2008 and 8 of the 10 were adopted This
endorsement of the Consensus Stroke Performance
Measures has paved the way for adoption of
these measures by the Centers for Medicare
and Medicaid Services for quality reporting and
meaningful use
Quarterly Data Reports With the implementation
of the Consensus Stroke Performance Measures in
January 2008 CDC began providing states with
quarterly data reports on the measures These
reports provide each state with a summary of its
data on ischemic stroke hemorrhagic stroke and
transient ischemic attacks as well as aggregate data
for all states in the Coverdell Registry program
Applied Research and Evaluation Branch
Building an Economic Evaluation Research Agenda
Based on program needs and research gaps in heart
disease and stroke prevention the Applied Research
and Evaluation Branch developed an agenda to
guide economic research on 1) economic burden
of cardiovascular diseases and cost-effectiveness of
their control 2) economic value of DHDSP-funded
and other state prevention programs 3) CDCrsquos
Internet-based clearinghouse for information on
the economics of cardiovascular diseases and 4)
developing partnerships in economic research to
increase the impact of such research
Stroke Awareness Signs and Symptoms Awareness Campaigns
To provide guidance for state programs a review of
current research on stroke awareness campaigns was
undertaken to identify evidence to support the most
appropriate ways to increase knowledge of signs and
symptoms for stroke the importance of calling 9-1-1
and relationships between the educational campaigns
and outcomes related to awareness of stroke signs
and symptoms
The literature review and synthesis of current
research on stroke awareness campaigns resulted
in the following dissemination activities
bull Development of a fact sheet for state programs on
literature review findings and considerations for
statesrsquo current activities related to stroke awareness
messages including direct education and tools
available to facilitate campaign development
bull Poster presentation at the 2008 National
Conference on Health Communication Marketing
and Media on evaluation guidance for stroke
awareness campaigns The presentation outlined
specific information for states and communities on
how to strengthen the effectiveness and outcome
evaluation of their stroke awareness campaigns
bull Presentation at the 2008 National Heart Disease
and Stroke Prevention Training Institute about
evidence and research on communication and
media campaigns impact considerations of cost
opportunities for partnering and evaluating
results
Comprehensive and Core Indicators
DHDSP released a set of core indicators for
hypertension as part of a comprehensive evidence-
based set of indicators to guide state heart disease
and stroke prevention programs in evaluating their
efforts State health departments received related
key guidance documents training at the National
Heart Disease and Stroke Prevention Training
Institute and a series of follow-up trainings
Indicators are presented in a Consumer Reports
format and rated on multiple dimensions such as
strength of scientific evidence feasibility of data
collection and face validity
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
12
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkitmdash Evaluation Results
CDC worked with the American Institutes for
Research (AIR) to conduct an evaluation of the
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit State health departments
(SHDs) were trained to use the toolkit to promote
state employer-based initiatives on workplace efforts
for heart disease and stroke prevention
From 2005 to 2007 all the SHDs received copies of
the toolkit and were invited to attend training sessions
(one seminar five webinars and three consultations)
To evaluate the usefulness of the toolkit materials
and obtain recommendations two focus groups with
business leaders and Web-based surveys of the SHDs
were conducted In 2006 all 50 states and the District
of Columbia completed the baseline and in 2008 40
states completed the follow-up
Of the 40 SHDs that completed both waves of the
survey the proportion that reported engaging in
employer-based initiatives significantly increased
from 65 percent to 725 percent during the period
examined despite a reported reduction in staff and
limited appropriations About 90 percent of the
SHDs that responded to the 2008 survey are now
working with employers to promote comprehensive
heart disease and stroke prevention programs
disseminate best practices establish employer-
oriented partnerships participate in seminars for
employers and provide business leaders with
resources Partnerships with employer groups or
business coalitions have focused on worksite policy
changes health promotion and education and
worksite surveillance and assessments In parallel
to these experiences the SHDs have increased their
overall level of confidence in their knowledge and
skills Most of the SHDs (61 percent) agreed that
the CDC trainings and consultations helped them
improve their heart disease and stroke prevention
programs and use the toolkit more effectively
Participation in the trainings was positively associated
with engagement in worksite health promotion and
education The SHDs that received federal funding
had significantly higher participation in macro-
marketing activities reaching employers through
business coalitions associations task forces and
champions and were more likely to establish
partnerships with employer groups and government
agencies
The Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit is available at wwwcdc
govdhdsplibrarytoolkitindexhtm
The Branch also provides economics support to
the Division and partners by documenting costs of
cardiovascular diseases and their risk factors and
identifying cost-effective interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
13
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
National Heart Disease and Stroke Prevention Program Overview
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
14
u Blood pressure Prevent and control high blood Program Overview pressure reduce sodium intake
bull In 1998 the US Congress provided funding
for CDC to initiate a national state-based Heart
Disease and Stroke Prevention (HDSP) program in
eight states
bull CDC funds programs in 41 states and the
District of Columbia Twenty-eight are capacity
building (planning) programs and 14 are basic
implementation (intervention) programs
bull Capacity Building Programs Alabama
Alaska Arizona California Colorado Connecticut
District of Columbia Hawaii Idaho Illinois Iowa
Kansas Kentucky Louisiana Maryland Michigan
Minnesota Mississippi Nebraska New Jersey
North Dakota Ohio Oklahoma Oregon Rhode
Island Tennessee Texas and Wisconsin
bull Basic Implementation Programs Arkansas
Florida Georgia Maine Massachusetts Missouri
Montana New York North Carolina South
Carolina Utah Virginia Washington and West
Virginia
National Heart Disease and Stroke Prevention Program Goals bull Enhance state capacity to plan implement track
and sustain population-based interventions to
address heart disease stroke and related risk
factors Focus program efforts on population-
based policy and systems change strategies to
impact the ldquoABCSrdquo of heart disease and stroke
prevention
u Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
u Cholesterol Prevent and control high
cholesterol
u Smoking Increase the number of smokers
counseled to quit and referred to quitlines by
health care workers increase availability of no
or low-cost cessation products and collaborate
with efforts to increase the percentage of the
population protected by smoke-free air laws
and regulations
To a lesser extent state HDSP programs work to
improve emergency response and quality of acute
care systems
State HDSP programs work to eliminate health
disparities in priority populations (ie groups with
increased burden or need based on race ethnicity
gender geography or socioeconomic status) as an
overarching principle
bull Collaborate with chronic disease programs (eg
those focusing on tobacco diabetes physical
inactivity poor nutrition and obesityoverweight)
and partners to develop and integrate population-
based strategies to prevent heart disease and
stroke
bull Promote cardiovascular health in health care
worksite and community settings through policy
and systems changes
bull Identify and evaluate promising practices to
address heart disease and stroke
bull Conduct surveillance of heart disease stroke
and related risk factors
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
15
u
u
Key Responsibilities of State Capacity Building Programs bull Facilitate collaboration with public- and private-
sector partners such as not-for-profit health
agencies health systems organizations emergency
response agencies federally funded health centers
businesses priority population organizations and
voluntary health organizations
bull Document the state burden of heart disease
stroke and related risk factors
bull Develop plans for population-based strategies
for preventing heart disease and stroke among
general and Priority Populations
bull Develop a comprehensive state HDSP plan
bull Develop an HDSP program logic model and
evaluation plan
bull Assess assets and gaps in state policy and systems
related to HDSP in health care worksite and
community settings
Key Responsibilities of State Basic Implementation Programs bull Enhance all capacity-building program activities
bull Implement and evaluate policy systems change
and educational interventions that address the
six HDSP program priority areas in health care
worksite and community settings
bull Provide training and technical assistance to
public health and health care professionals and
partners to support policy and system changes
that will encourage heart disease and stroke
prevention
How CDC Assists State Heart Disease and Stroke Prevention Programs bull Provides training technical assistance and
funding
bull Funds applied research on heart disease and
stroke interventions and elimination of disparities
that is relevant to state programs
bull Identifies and disseminates science-based
promising practices
bull Partners with national organizations to help states
address prevention of heart disease and stroke
bull Facilitates collaborations with other state chronic
disease programs or activities that address risk
factors populations or settings related to heart
disease and stroke prevention and program
priority areas
bull Develops and disseminates publications and tools
such as
u CDCynergy a CD-ROM-based tool for
planning health communication interventions
State Heart Disease and Stroke Prevention
Program Evaluation Framework (wwwcdc
govdhdsplibraryevaluation_framework
indexhtm) a document providing guidance
on systematic ways to measure the success of
public health programs and on logic model
development
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping an
Evaluation Plan (wwwcdcgovDHDSPstate_
programevaluation_guidesevaluation_plan
htm) a document providing guidance on the
development of evaluation activities to help
programs identify required staff time and
resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
16
u
u
u
u
u
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping and
Using a Logic Model (wwwcdcgovDHDSP
state_programevaluation_guideslogic_model
htm) a document providing guidance on
the development and use of logic models as
planning and evaluation tools
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashWriting SMART
Objectives (wwwcdcgovDHDSPstate_
programevaluation_guidessmart_objectives
htm) a document providing guidance to
states on the development of realistic and
measurable objectives
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit (wwwcdcgov
dhdsplibrarytoolkitindexhtm) a document
that provides information materials and
tools that state programs can reference and
distribute to businesses primarily through
employer and professional organizations
Heart Disease and Stroke Interactive Maps
(wwwcdcgovdhdsplibrarymapsstatemaps
htm) which present heart disease and stroke
mortality rates by county for the state racial
ethnic group and gender of the userrsquos choice
A Communication Guide for Policy and
Environmental Change (wwwcdcgovdhdsp
libraryheart_stroke_guideindexhtm) which
includes information references and examples
of communication from state programs and
Stroke Addendum to the Communication
Guide (wwwcdcgovdhdsplibraryheart_
stroke_guideindexhtm)
For additional information please visit the CDC
website at wwwcdcgovdhdsp or contact the
Division for Heart Disease and Stroke Prevention
Program Development and Services Branch at
(770) 488-2424
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
17
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
State Heart Disease and Stroke Prevention Program Funding Opportunity Announcement DP07-704 At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
18
Introduction The Funding Opportunity Announcement
(FOA) DP07-704 At-A-Glance provides important
information to assist programs funded under this
announcement to deliver their program as intended
The At-A-Glance highlights aspects of FOA DP07-704
important for all funded programs including
the following
bull Overview of the National Heart Disease and
Stroke Prevention Program
bull Heart Disease and Stroke Prevention State
Program roles
bull Performance measures for Capacity Building Basic
Implementation Optional Funding for Capacity
Building programs and Stroke Networks
bull Funded program reporting requirements
bull Budgetfunding guidance
bull National and administrative policy requirements
If a program needs a copy of the full document
it should contact its project officer (see Program
Contacts section of the full National Heart Disease
and Stroke Prevention Program Staff Orientation
Manual) to fulfill that request
Section 1 Background In 1998 the US Congress provided funding for
CDC to initiate a national state-based cardiovascular
health program The Senate Appropriations
Committee in 2005 encouraged CDC to create the
Division for Heart Disease and Stroke Prevention and
increased resources enabling CDC to reach 32 of the
50 states and the District of Columbia with funding
for heart disease and stroke prevention As of 2008
the Heart Disease and Stroke Prevention (HDSP)
program funds 41 states and the District of Columbia
As the Division for Heart Disease and Stroke
Prevention developed so did the focus of the State
HDSP Program Focusing on the six program priority
areas (noted below) should impact morbidity and
mortality of these diseases State programs should
increase heart disease and stroke prevention policies
and systems change with the potential to impact
the general population and Priority Populations
(see Prevention Works CDC Strategies for a Heart-
healthy and Stroke-free America wwwCDCgov
dhdsplibrary) For more information on the CDC
State HDSP Program visit wwwcdcgovdhdspState_
programindexhtm
A Public Health Action Plan to Prevent Heart Disease
and Stroke (see wwwCDCgovdhdsplibrary)
documents the multiple intervention opportunities
for preventing heart disease and stroke It is
important to work with partners collaboratively in
leveraging resources to address the multiple risk
factors that are associated with these diseases
Announcement DP07-704 supports program
components considered essential to enhancing
the leadership of state health departments in
heart disease and stroke prevention It provides
for the funding of capacity building and basic
implementation programs as well as projects such as
the Optional Funding for Capacity Building Programs
and Stroke Networks
A capacity building program develops the foundation
for a comprehensive cardiovascular disease prevention
program through such activities as partnership
development definition of the burden and
development of a state plan A basic implementation
program enhances capacity building activities and
implements disseminates and evaluates intervention
activities that address the state plan objectives and the
CDC program priority areas 1ndash6
1 Increase control of high blood pressure primarily
in adults and older adults
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19
2 Increase control of high blood cholesterol
primarily in adults and older adults
3 Increase knowledge of signs and symptoms for
heart attack and stroke and the importance of
calling 9-1-1
4 Improve emergency response
5 Improve quality of heart disease and stroke care
6 Eliminate disparities in terms of race ethnicity
gender geography or socioeconomic status
Optional Funding for Capacity Building Programs
provides support to programs to implement an
evidence-based or promising practice demonstration
project that addresses the CDC program priority
areas 1ndash6
Stroke Networks support a state health department to
increase stroke prevention activities across a group of
three to six contiguous member states with emphasis
on increasing awareness and implementing priority
policy or systems changes across the states
The State HDSP Program is anchored on the
framework of the Socio-ecological Model which
conceptualized the influences of individual
behaviors family and social relationships community
and environmental effects and societal influences
such as policies on health status In order to
promote significant impact for improving the health
of the population interventions should focus on
implementing policy and systems change strategies
that support heart disease and stroke prevention
Policy change can be addressed through a) public
policy (eg establishing certification for hospital-
based stroke centers) or b) organizational policy
(eg businesses providing health benefits plans
that cover preventive services that include blood
pressure control)
System changes are encouraged in three settings
worksites health care and communities An
example of a systems change is when a health
care setting implements electronic records and
patient care management systems that improve the
quality of health care Interventions within systems
are encouraged at the highest level possiblemdashfor
example activities with business coalitions rather
than individual worksites and with managed care
organizations (MCOs) and state medical associations
rather than individual health care sites or physicians
By working at higher levels to affect systems change
states can impact larger segments of the population
Education and awareness efforts to enhance
public understanding and promote actions related
to cardiovascular diseases and the risk factors of
high blood pressure and high cholesterol signs
and symptoms of heart attack and stroke and the
need to call 9-1-1 are also components of capacity
enhancement
An overarching goal of the State HDSP Program
is to address disparities in heart disease and
stroke and the related risk factors using policy and
systems change strategies Based on disparities
(eg raceethnicity gender geographic geography
socioeconomic status) in mortality access to care
or burden of risk factors the State HDSP Program
should identify Priority Populations and implement
interventions to reach those Priority Populations
No one organization will be able to address the
prevention of heart disease and stroke It will require
many organizations working in collaboration if
progress is to be made in accomplishing the Healthy
People 2010 Objectives Collaboration is defined
by the Wilder Foundation as ldquoa mutually beneficial
and well-defined relationship entered into by two
or more organizations to achieve common goals
The relationship includes a commitment to mutual
relationships and goals a jointly developed structure
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20
and shared responsibility mutual authority and
accountability for success and sharing of resources
and rewardsrdquo Developing and maintaining
strategic partnerships are key to the leveraging of
skills and resources to prevent heart disease and
stroke in a comprehensive way The State HDSP
Program has two major roles related to partners
The first is to convene or facilitate collaboration
to develop and implement a comprehensive state
plan and intervention implementation strategies
that addresses heart disease stroke and related
risk factors The second is to develop strategies to
leverage resources and coordinate interventions
with partners that address the six program
priority areas
A logic model has been developed to describe
the State HDSP Program as intended by the CDC
funding to state health departments (see following
page) The model depicts relationships and actions
(eg links between environment and policy
change and individual-level behavioral change)
that are expected to culminate in reduction in
heart disease and stroke
The CDC and state activities are outlined in terms
of capacity building surveillancemonitoring
and interventions Both CDC and state activities
influence changes that lead to short-term
outcomes such as development of a work plan
and strategies for system-level changes effective
implementation of interventions and action by
target audiences and change agents (those who are
in the position to influence policies and systems
such as hospital administrators and MCO decision
makers) These activities and outcomes result in
changes in policy and environmental supports
which in turn influence behavior changes and
improve health status Ultimately these changes
decrease premature death and disability and
eliminate cardiovascular disparities between
general and Priority Populations
The State HDSP logic model also is a tool to guide
program evaluation By identifying the steps
necessary to reach intended outcomes the logic
model provides guidance in evaluating the short and
intermediate outcomes of the program
State evaluation efforts should relate to the National
HDSP Program logic model or to a logic model that
the state develops that complements the national
model and the required program recipient activities
The logic model can also be seen in the CDC
Evaluation Framework for Heart Disease and Stroke
Prevention State Programs at wwwcdcgovdhdsp
Section 2 National Heart Disease and Stroke Prevention State Program Roles In A Public Health Action Plan to Prevent Heart
Disease and Stroke there are four major goals which
are based on Healthy People 2010
Goal 1 Prevention of risk factors
Goal 2 Detection and treatment of risk factors
Goal 3 Early identification and treatment of heart
attacks and strokes
Goal 4 Prevention of recurrent cardiovascular events
CDC-funded State HDSP Programs have a direct
impact on Goals 2 3 and 4 by addressing HDSP
program priority areas 1ndash6 (see Background section)
HDSP programs have a supportive role with other
state health department programs and partners in
addressing Goal 1 Efforts to address Goal 1 related
to tobacco use diabetes obesity poor nutrition
physical inactivity and schools as a worksite should
be done through a supportive or collaborative role
with the state WISEWOMAN diabetes tobacco
nutrition physical activity or coordinated school
health programs
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bull State HDSP Programs are encouraged to
coordinate with other programs in ways that
1 Address Goal 1 (eg State HDSP and Nutrition
Programs identify primary prevention messages
related to cholesterol and salt to be included in Nushy
trition Programs where appropriate State HDSP and
Tobacco Programs collaborate to promote use of
state tobacco quit lines State HDSP Program refers
managed care organizations to materials developed
by the Parks and Recreation Department and
Physical Activity Program on safe places to exercise
National HDSP Program Logic Model
State HDSP and WISEWOMAN Programs collaborate
to create systems for educating health care providers
on guidelines focused on risk factor prevention)
2 Enhance inclusion of key messages in the work
of related programs (eg State HDSP Program
works to implement JNC7 guidelines which
include referral to nutrition counseling the
WISEWOMAN Program incorporates education on
signs and symptoms of heart disease and stroke
into ongoing activities the State HDSP Program
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and system change supports
Level bull State bull Local
Settings bull Community bull Health care bull Worksite
Context bull Priority
Populations bull General
populations
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective intervention
implemented focused on
settings and Priority Populations
Change agents
take action
Activate intended audiences
Capa
city B
uildin
gSu
rveil
lance
Inter
vent
ions
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
21
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
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23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
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26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
6
2010 Funded Programs
2011 Funded Programs
NHDSP Funded States
WISEWOMAN Programs
WA
MT
ID WY
NV
AK
HI
AZ NM
TX
KSCO
OK
SD
ND
AR
IN OH
KY
TN
LA ALMS
FL
GA
NY
ME
OR
UT
CA
NE IA
MO
WI
IL
MN
MI
VAWV
SC
NC
PA NH
DE
VT
MD
NJ
RI
DC
MA
CT
Coverdell Stroke Registry States
Sodium Reduction Communities
Unfunded States
Note WISEWOMAN funds two tribal organizations in Alaska but not the state health department
Congress authorized the program in 1993 as an
expansion of services offered through the National
Breast and Cervical Cancer Early Detection Program
DHDSP funds WISEWOMAN programs in 19 states
and 2 tribal organizations Working in local clinics
and health care settings WISEWOMAN provides
heart disease and stroke risk factor screenings and
offers lifestyle interventions to help women increase
their physical activity improve their diet and engage
in tobacco cessation efforts
Paul Coverdell National Acute Stroke Registry
DHDSP funds states to establish surveillance systems
that measure track and provide data to help improve
the delivery and quality of stroke care among acute
stroke patients In 2001 Congress funded CDC to
establish the Paul Coverdell National Acute Stroke
Registry after US Senator Paul Coverdell of Georgia
suffered a fatal stroke while serving in Congress
The goal of the Coverdell Registry is to ensure that
all stroke patients receive the highest quality acute
stroke care available to reduce untimely deaths
prevent disability and avoid recurrent strokes With
Coverdell Registry data states and their health care
partners identify and analyze gaps in stroke care
systems and plan targeted strategies to address
them In June 2004 CDC funded four state health
departments (Georgia Illinois Massachusetts
and North Carolina) to establish Paul Coverdell
National Acute Stroke Registries In the most recent
Paul Coverdell National Acute Stroke Registry
funding cycle (2007ndash2011) CDC funded state health
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
7
departments in Georgia Massachusetts Michigan
Minnesota Ohio and North Carolina In 2007
CDC The Joint Commissionrsquos Primary Stroke Center
Certification program and the American Heart
AssociationAmerican Stroke Associationrsquos Get With
The Guidelinesreg-Stroke program jointly released a set
of standardized stroke performance measures to be
used by all three programs This effort has reduced
duplication of effort increased collaboration and
encouraged hospitals to participate in the programs
Office of the Director
Mississippi Delta Health Collaborative (Delta Health Initiative)
The Mississippi Delta Health Collaborative (MDHC)
is designed to prevent heart disease stroke and
related chronic diseases Through a new five-year
cooperative agreement this initiative will intensify
collaboration among the Mississippi Department of
Health existing chronic disease programs (eg heart
disease and stroke prevention diabetes tobacco
nutrition physical activity) local health departments
other community health care providers (eg
federally qualified health centers) local communities
and CDC This result will be achieved through
implementation of interventions across Mississippirsquos
18-county Delta Region The program will target
the ldquoABCSrdquo of heart disease and stroke prevention
among priority populations in high burden
underserved rural areas
bull Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
bull Hemoglobin A1c (HbA1c) Monitor and control
blood glucose
bull Blood pressure Prevent and control high blood
pressure
bull Cholesterol Prevent and control high LDL-
cholesterol
bull Smoking Prevent initiation and increase cessation
of smoking and increase the percentage of the
population protected by smoke-free air laws or
regulations
The Mississippi Department of Health will provide
leadership and funding support in the Delta
Region to implement prioritized population-based
interventions policy systems and environmental
change selected as appropriate from a set of
prescribed evidence-based strategies in both the
clinical and community settings
WISEWOMAN
The WISEWOMAN Program began a new five-
year funding cycle June 30 2008 The competitive
application process resulted in 21 programs being
funded This is an increase of six programs from the
previous funding cycle Seventeen WISEWOMAN
programs also receive funding to implement the
National Heart Disease and Stroke Prevention
Program
One major focus of the funding opportunity
announcement (FOA) is development of partnerships
At a minimum funded programs are expected to
partner with their statetribal Breast and Cervical
Cancer Early Detection Program Tobacco Control
Program Heart Disease and Stroke Prevention
ProgramCoalition and other programs that
can affect policies and environments in which
WISEWOMAN participants live work and play
Because the majority of WISEWOMAN funding must
be spent on providing direct services to women
partnerships are extremely important to ensure
participant access to affordable and quality resources
to support heart health
WISEWOMAN evaluation emphasizes program
improvement and is based on the CDC Framework
for Program Evaluation in Public Health CDC has
developed key evaluation questions related to the
programrsquos stated goals and logic model components
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
8
The questions are used in the evaluation of the
WISEWOMAN Program Funded programs are
required to conduct evaluations to assess progress
toward meeting stated work plan objectives and to
share results with others including their providers
partners other stakeholders and CDC Funded
programs contribute to the WISEWOMAN Program
evaluation by providing Minimum Data Elements
data submitting information to CDC that supports
program evaluation activities and participating in
activities such as site visits and case studies
Sodium Reduction in Communities
High sodium consumption is a major contributor
to high blood pressure a leading cause of stroke
coronary heart disease heart attack and heart and
kidney failure in the United States The 2010 Dietary
Guidelines for Americans recommend limiting
sodium to less than 2300 milligrams (mg) per day
Individuals who are 51 and older and those of any
age who are African American or have hypertension
diabetes or chronic kidney disease should limit
intake to 1500 mg of sodium per day These groups
account for about half the US population and the
majority of adults
Studies show that on average US adults consume
more than 3400 mg of sodium per day An estimated
77 percent of sodium comes from processed and
restaurant foods Reducing dietary intake of sodium
to 2300 mg per day could prevent as many as 11
million cases of hypertension in the United States
Further reductions in sodium intake to 1500 mg per
day could prevent more than 16 million cases
Through the three-year Sodium Reduction in
Communities cooperative agreement which began in
September 2010 DHDSP is providing support to six
communities to support policy changes designed to
create healthier food environments The communities
receiving support include California (Shasta County)
Kansas (Shawnee County) Los Angeles County
New York City and New York State (Broome and
Schenectady counties)
Program Development and Services Branch
Funded State Programs
National Heart Disease and Stroke Prevention Program The enhanced reach of the National
Heart Disease and Stroke Prevention Program was
a key accomplishment in 2008 Eight new states
(Connecticut Hawaii Idaho Iowa Maryland New
Jersey North Dakota and West Virginia) were funded
as part of the program bringing the total number of
funded programs to 42
Leadership to Center Integration PDSB has
provided leadership to NCCDPHPrsquos initiative to
increase synergy reach and desired health outcomes
in selected NCCDPHP-funded categorical programs
(National Heart Disease and Stroke Prevention
Diabetes Prevention and Control Tobacco Control
Comprehensive Cancer Control Nutrition Physical
Activity and Obesity and the Behavioral Risk Factor
Surveillance System)
National Training DHDSP conducted the 2008
National Heart Disease and Stroke Prevention
Training Institute on September 9ndash11 in Atlanta The
training focused on longer skill-building interactive
workshops that addressed the competencies
program priorities and performance measures of
the FOAs for DHDSPrsquos funded programs It included
the National Heart Disease and Stroke Prevention
Program and WISEWOMAN and was expanded to
include representation from each statersquos heart disease
program as well as American Heart Association
field staff working in the states Informal feedback
indicates that the training has already led to greater
collaboration at the state level
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
9
Management Information System (MIS) In 2008
DHDSP completed revisions for the heart disease
and stroke prevention Web-based MIS The report
generated by the system was changed to a table that
displays an objective time frame status and progress
in an easy-to-read format These changes made the
system more user friendly for states and CDC The
MIS can now be used to
bull Describe state program activities and expected
use of CDC funds
bull Track progress on state program activities and
identify promising practices
bull Assist CDC in identifying the need for training
and technical assistance
bull Standardize the state reporting process to
facilitate evaluation
bull Enable CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Funded Partnerships
Directors of Health Promotion and Education
(DHPE) In 2008 DHDSP continued to support
the DHPECDC Internship Program for Students
of Minority Serving Institutions
National Stroke Association DHDSP assisted with
funding for the Sixth Annual National Public Health
Stroke Summit conducted by the National Stroke
Association in Denver Colorado in December 2007
The Summit brought together 105 state public health
and health care professionals to promote information
sharing knowledge and skill building networking
and partnership development
National Collaborations
Cardiovascular Health (CVH) Council of the National Association of Chronic Disease Directors (NACDD) In 2008 the CVH Council
updated its section of the NACDD website to include
additional materials useful to states and it started
a Web discussion forum that allows states to share
ideas and products The Council obtained private
funds and sponsored the 2-day Northeast Regional
Workshop on Cholesterol Control in which 11
states participated in May 2008 It also funded two
of the participating states (Maine and Maryland)
to do follow-up work on cholesterol control with
their primary care associations and local federally
qualified health centers In March 2008 the
Council led the development of a themed issue of
the e-journal Preventing Chronic Disease In most
cases state program staff coauthored articles with
DHDSP staff The CVH Council worked with DHDSP
to assess the training needs of state programs in
the National Heart Disease and Stroke Prevention
Program and DHDSP used this information to plan
its September 2008 3-day training workshop for state
program and WISEWOMAN staff
Epidemiology and Surveillance Branch
Cardiac Arrest Registry to Enhance Survival
The Cardiac Arrest Registry to Enhance Survival
(CARES) began in 2005 in Atlanta and has since
expanded to 40 communities in 23 states CARES is
a simple but robust registry of cardiac arrest events
that allows participating sites to enter data related
to out-of-hospital cardiac arrest (OHCA) generate
summary reports and compare local data with
similar EMS systems elsewhere Three sources of
data are linked to describe each OHCA event 1)
9-1-1 call center data (to provide incident address
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
10
and dispatch and arrival times) 2) EMS data (to
describe initially recorded cardiac rhythm and
treatment methods) and 3) hospital data (emergency
department and hospital outcome hypothermia
treatment and neurologic status at discharge)
Multiple reporting features can be generated and
monitored continuously through secure online access
by CARES participants which allows for longitudinal
internal benchmarking Local EMS administrators
and medical directors are able to identify when and
where cardiac arrests occur which elements of their
EMS system are functioning properly in dealing
with these cases and what changes can be made to
improve outcomes In 2011 CARES began expanding
to statewide participation in six states which will
allow additional communities of different sizes and
population densities to be included in the registry In
addition state-level participation will promote better
communication and collaboration between state and
local EMS providers A recent MMWR Surveillance
Summary was published summarizing CARES data
collected during October 1 2005ndashDecember 31
2010 (wwwcdcgovmmwrpdfssss6008pdf) More
information about CARES can be found on the
CARES website at httpsmycaresnet
Paul Coverdell National Acute Stroke Registry
New Registries The Paul Coverdell National
Acute Stroke Registry program successfully
implemented stroke registries in three newly
funded states in 2007 (Michigan Minnesota and
Ohio) These states made much greater progress
in their first year toward developing program
infrastructure collecting data and engaging in
quality improvement activities than had the four
states that completed their first year of Coverdell
Registry funding in 2004 Much of this progress can
be attributed to CDCrsquos increased capacity to provide
proactive technical assistance to states through
conference calls work groups and resource
materials such as the program resource manual
Supplemental Projects The Coverdell Registry
team developed and funded a supplemental
cooperative agreement to pilot the expansion of
the Coverdell Registry model to other domains
within stroke systems of care North Carolina was
funded to demonstrate the feasibility of linking
pre-hospital EMS data for stroke with the state
Coverdell Registry (the North Carolina Stroke
Care Collaborative) In 2010 in partnership with
the Association of State and Territorial Health
Officials CDC funded two Coverdell states to
develop comprehensive statewide stroke care
systems plans CDC is currently funding the Ohio
Coverdell Registry to study 30-day outcomes
of stroke patients based on the quality of care
provided In partnership with the Agency for
Healthcare Research and Quality CDC has funded
an evidence-based review of transitions in care
from hospital to home or rehabilitation for stroke
patients
National Evaluation Plan Through a yearlong
collaboration with RTI International the Coverdell
Registry developed a national evaluation plan The
plan provides a systematic method of assessing
the annual and long-term performance of the
program including strategic goals and objectives
performance goals performance measures and
targets for program outcomes
Consensus Stroke Performance Measures
Endorsement of the Consensus Stroke
Performance Measures The Coverdell Registry
partnered with the American Heart Association
and The Joint Commission to develop performance
measures for acute stroke care commonly
referred to as the Consensus Stroke Performance
Measures These measures were released to
hospitals throughout the United States in fall
2007 In January 2008 more than 1200 hospitals
began using these measures to improve the quality
of care for acute stroke patients The measures
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
11
were submitted to the National Quality Forum in
March 2008 and 8 of the 10 were adopted This
endorsement of the Consensus Stroke Performance
Measures has paved the way for adoption of
these measures by the Centers for Medicare
and Medicaid Services for quality reporting and
meaningful use
Quarterly Data Reports With the implementation
of the Consensus Stroke Performance Measures in
January 2008 CDC began providing states with
quarterly data reports on the measures These
reports provide each state with a summary of its
data on ischemic stroke hemorrhagic stroke and
transient ischemic attacks as well as aggregate data
for all states in the Coverdell Registry program
Applied Research and Evaluation Branch
Building an Economic Evaluation Research Agenda
Based on program needs and research gaps in heart
disease and stroke prevention the Applied Research
and Evaluation Branch developed an agenda to
guide economic research on 1) economic burden
of cardiovascular diseases and cost-effectiveness of
their control 2) economic value of DHDSP-funded
and other state prevention programs 3) CDCrsquos
Internet-based clearinghouse for information on
the economics of cardiovascular diseases and 4)
developing partnerships in economic research to
increase the impact of such research
Stroke Awareness Signs and Symptoms Awareness Campaigns
To provide guidance for state programs a review of
current research on stroke awareness campaigns was
undertaken to identify evidence to support the most
appropriate ways to increase knowledge of signs and
symptoms for stroke the importance of calling 9-1-1
and relationships between the educational campaigns
and outcomes related to awareness of stroke signs
and symptoms
The literature review and synthesis of current
research on stroke awareness campaigns resulted
in the following dissemination activities
bull Development of a fact sheet for state programs on
literature review findings and considerations for
statesrsquo current activities related to stroke awareness
messages including direct education and tools
available to facilitate campaign development
bull Poster presentation at the 2008 National
Conference on Health Communication Marketing
and Media on evaluation guidance for stroke
awareness campaigns The presentation outlined
specific information for states and communities on
how to strengthen the effectiveness and outcome
evaluation of their stroke awareness campaigns
bull Presentation at the 2008 National Heart Disease
and Stroke Prevention Training Institute about
evidence and research on communication and
media campaigns impact considerations of cost
opportunities for partnering and evaluating
results
Comprehensive and Core Indicators
DHDSP released a set of core indicators for
hypertension as part of a comprehensive evidence-
based set of indicators to guide state heart disease
and stroke prevention programs in evaluating their
efforts State health departments received related
key guidance documents training at the National
Heart Disease and Stroke Prevention Training
Institute and a series of follow-up trainings
Indicators are presented in a Consumer Reports
format and rated on multiple dimensions such as
strength of scientific evidence feasibility of data
collection and face validity
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
12
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkitmdash Evaluation Results
CDC worked with the American Institutes for
Research (AIR) to conduct an evaluation of the
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit State health departments
(SHDs) were trained to use the toolkit to promote
state employer-based initiatives on workplace efforts
for heart disease and stroke prevention
From 2005 to 2007 all the SHDs received copies of
the toolkit and were invited to attend training sessions
(one seminar five webinars and three consultations)
To evaluate the usefulness of the toolkit materials
and obtain recommendations two focus groups with
business leaders and Web-based surveys of the SHDs
were conducted In 2006 all 50 states and the District
of Columbia completed the baseline and in 2008 40
states completed the follow-up
Of the 40 SHDs that completed both waves of the
survey the proportion that reported engaging in
employer-based initiatives significantly increased
from 65 percent to 725 percent during the period
examined despite a reported reduction in staff and
limited appropriations About 90 percent of the
SHDs that responded to the 2008 survey are now
working with employers to promote comprehensive
heart disease and stroke prevention programs
disseminate best practices establish employer-
oriented partnerships participate in seminars for
employers and provide business leaders with
resources Partnerships with employer groups or
business coalitions have focused on worksite policy
changes health promotion and education and
worksite surveillance and assessments In parallel
to these experiences the SHDs have increased their
overall level of confidence in their knowledge and
skills Most of the SHDs (61 percent) agreed that
the CDC trainings and consultations helped them
improve their heart disease and stroke prevention
programs and use the toolkit more effectively
Participation in the trainings was positively associated
with engagement in worksite health promotion and
education The SHDs that received federal funding
had significantly higher participation in macro-
marketing activities reaching employers through
business coalitions associations task forces and
champions and were more likely to establish
partnerships with employer groups and government
agencies
The Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit is available at wwwcdc
govdhdsplibrarytoolkitindexhtm
The Branch also provides economics support to
the Division and partners by documenting costs of
cardiovascular diseases and their risk factors and
identifying cost-effective interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
13
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
National Heart Disease and Stroke Prevention Program Overview
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
14
u Blood pressure Prevent and control high blood Program Overview pressure reduce sodium intake
bull In 1998 the US Congress provided funding
for CDC to initiate a national state-based Heart
Disease and Stroke Prevention (HDSP) program in
eight states
bull CDC funds programs in 41 states and the
District of Columbia Twenty-eight are capacity
building (planning) programs and 14 are basic
implementation (intervention) programs
bull Capacity Building Programs Alabama
Alaska Arizona California Colorado Connecticut
District of Columbia Hawaii Idaho Illinois Iowa
Kansas Kentucky Louisiana Maryland Michigan
Minnesota Mississippi Nebraska New Jersey
North Dakota Ohio Oklahoma Oregon Rhode
Island Tennessee Texas and Wisconsin
bull Basic Implementation Programs Arkansas
Florida Georgia Maine Massachusetts Missouri
Montana New York North Carolina South
Carolina Utah Virginia Washington and West
Virginia
National Heart Disease and Stroke Prevention Program Goals bull Enhance state capacity to plan implement track
and sustain population-based interventions to
address heart disease stroke and related risk
factors Focus program efforts on population-
based policy and systems change strategies to
impact the ldquoABCSrdquo of heart disease and stroke
prevention
u Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
u Cholesterol Prevent and control high
cholesterol
u Smoking Increase the number of smokers
counseled to quit and referred to quitlines by
health care workers increase availability of no
or low-cost cessation products and collaborate
with efforts to increase the percentage of the
population protected by smoke-free air laws
and regulations
To a lesser extent state HDSP programs work to
improve emergency response and quality of acute
care systems
State HDSP programs work to eliminate health
disparities in priority populations (ie groups with
increased burden or need based on race ethnicity
gender geography or socioeconomic status) as an
overarching principle
bull Collaborate with chronic disease programs (eg
those focusing on tobacco diabetes physical
inactivity poor nutrition and obesityoverweight)
and partners to develop and integrate population-
based strategies to prevent heart disease and
stroke
bull Promote cardiovascular health in health care
worksite and community settings through policy
and systems changes
bull Identify and evaluate promising practices to
address heart disease and stroke
bull Conduct surveillance of heart disease stroke
and related risk factors
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
15
u
u
Key Responsibilities of State Capacity Building Programs bull Facilitate collaboration with public- and private-
sector partners such as not-for-profit health
agencies health systems organizations emergency
response agencies federally funded health centers
businesses priority population organizations and
voluntary health organizations
bull Document the state burden of heart disease
stroke and related risk factors
bull Develop plans for population-based strategies
for preventing heart disease and stroke among
general and Priority Populations
bull Develop a comprehensive state HDSP plan
bull Develop an HDSP program logic model and
evaluation plan
bull Assess assets and gaps in state policy and systems
related to HDSP in health care worksite and
community settings
Key Responsibilities of State Basic Implementation Programs bull Enhance all capacity-building program activities
bull Implement and evaluate policy systems change
and educational interventions that address the
six HDSP program priority areas in health care
worksite and community settings
bull Provide training and technical assistance to
public health and health care professionals and
partners to support policy and system changes
that will encourage heart disease and stroke
prevention
How CDC Assists State Heart Disease and Stroke Prevention Programs bull Provides training technical assistance and
funding
bull Funds applied research on heart disease and
stroke interventions and elimination of disparities
that is relevant to state programs
bull Identifies and disseminates science-based
promising practices
bull Partners with national organizations to help states
address prevention of heart disease and stroke
bull Facilitates collaborations with other state chronic
disease programs or activities that address risk
factors populations or settings related to heart
disease and stroke prevention and program
priority areas
bull Develops and disseminates publications and tools
such as
u CDCynergy a CD-ROM-based tool for
planning health communication interventions
State Heart Disease and Stroke Prevention
Program Evaluation Framework (wwwcdc
govdhdsplibraryevaluation_framework
indexhtm) a document providing guidance
on systematic ways to measure the success of
public health programs and on logic model
development
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping an
Evaluation Plan (wwwcdcgovDHDSPstate_
programevaluation_guidesevaluation_plan
htm) a document providing guidance on the
development of evaluation activities to help
programs identify required staff time and
resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
16
u
u
u
u
u
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping and
Using a Logic Model (wwwcdcgovDHDSP
state_programevaluation_guideslogic_model
htm) a document providing guidance on
the development and use of logic models as
planning and evaluation tools
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashWriting SMART
Objectives (wwwcdcgovDHDSPstate_
programevaluation_guidessmart_objectives
htm) a document providing guidance to
states on the development of realistic and
measurable objectives
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit (wwwcdcgov
dhdsplibrarytoolkitindexhtm) a document
that provides information materials and
tools that state programs can reference and
distribute to businesses primarily through
employer and professional organizations
Heart Disease and Stroke Interactive Maps
(wwwcdcgovdhdsplibrarymapsstatemaps
htm) which present heart disease and stroke
mortality rates by county for the state racial
ethnic group and gender of the userrsquos choice
A Communication Guide for Policy and
Environmental Change (wwwcdcgovdhdsp
libraryheart_stroke_guideindexhtm) which
includes information references and examples
of communication from state programs and
Stroke Addendum to the Communication
Guide (wwwcdcgovdhdsplibraryheart_
stroke_guideindexhtm)
For additional information please visit the CDC
website at wwwcdcgovdhdsp or contact the
Division for Heart Disease and Stroke Prevention
Program Development and Services Branch at
(770) 488-2424
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
17
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
State Heart Disease and Stroke Prevention Program Funding Opportunity Announcement DP07-704 At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
18
Introduction The Funding Opportunity Announcement
(FOA) DP07-704 At-A-Glance provides important
information to assist programs funded under this
announcement to deliver their program as intended
The At-A-Glance highlights aspects of FOA DP07-704
important for all funded programs including
the following
bull Overview of the National Heart Disease and
Stroke Prevention Program
bull Heart Disease and Stroke Prevention State
Program roles
bull Performance measures for Capacity Building Basic
Implementation Optional Funding for Capacity
Building programs and Stroke Networks
bull Funded program reporting requirements
bull Budgetfunding guidance
bull National and administrative policy requirements
If a program needs a copy of the full document
it should contact its project officer (see Program
Contacts section of the full National Heart Disease
and Stroke Prevention Program Staff Orientation
Manual) to fulfill that request
Section 1 Background In 1998 the US Congress provided funding for
CDC to initiate a national state-based cardiovascular
health program The Senate Appropriations
Committee in 2005 encouraged CDC to create the
Division for Heart Disease and Stroke Prevention and
increased resources enabling CDC to reach 32 of the
50 states and the District of Columbia with funding
for heart disease and stroke prevention As of 2008
the Heart Disease and Stroke Prevention (HDSP)
program funds 41 states and the District of Columbia
As the Division for Heart Disease and Stroke
Prevention developed so did the focus of the State
HDSP Program Focusing on the six program priority
areas (noted below) should impact morbidity and
mortality of these diseases State programs should
increase heart disease and stroke prevention policies
and systems change with the potential to impact
the general population and Priority Populations
(see Prevention Works CDC Strategies for a Heart-
healthy and Stroke-free America wwwCDCgov
dhdsplibrary) For more information on the CDC
State HDSP Program visit wwwcdcgovdhdspState_
programindexhtm
A Public Health Action Plan to Prevent Heart Disease
and Stroke (see wwwCDCgovdhdsplibrary)
documents the multiple intervention opportunities
for preventing heart disease and stroke It is
important to work with partners collaboratively in
leveraging resources to address the multiple risk
factors that are associated with these diseases
Announcement DP07-704 supports program
components considered essential to enhancing
the leadership of state health departments in
heart disease and stroke prevention It provides
for the funding of capacity building and basic
implementation programs as well as projects such as
the Optional Funding for Capacity Building Programs
and Stroke Networks
A capacity building program develops the foundation
for a comprehensive cardiovascular disease prevention
program through such activities as partnership
development definition of the burden and
development of a state plan A basic implementation
program enhances capacity building activities and
implements disseminates and evaluates intervention
activities that address the state plan objectives and the
CDC program priority areas 1ndash6
1 Increase control of high blood pressure primarily
in adults and older adults
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
19
2 Increase control of high blood cholesterol
primarily in adults and older adults
3 Increase knowledge of signs and symptoms for
heart attack and stroke and the importance of
calling 9-1-1
4 Improve emergency response
5 Improve quality of heart disease and stroke care
6 Eliminate disparities in terms of race ethnicity
gender geography or socioeconomic status
Optional Funding for Capacity Building Programs
provides support to programs to implement an
evidence-based or promising practice demonstration
project that addresses the CDC program priority
areas 1ndash6
Stroke Networks support a state health department to
increase stroke prevention activities across a group of
three to six contiguous member states with emphasis
on increasing awareness and implementing priority
policy or systems changes across the states
The State HDSP Program is anchored on the
framework of the Socio-ecological Model which
conceptualized the influences of individual
behaviors family and social relationships community
and environmental effects and societal influences
such as policies on health status In order to
promote significant impact for improving the health
of the population interventions should focus on
implementing policy and systems change strategies
that support heart disease and stroke prevention
Policy change can be addressed through a) public
policy (eg establishing certification for hospital-
based stroke centers) or b) organizational policy
(eg businesses providing health benefits plans
that cover preventive services that include blood
pressure control)
System changes are encouraged in three settings
worksites health care and communities An
example of a systems change is when a health
care setting implements electronic records and
patient care management systems that improve the
quality of health care Interventions within systems
are encouraged at the highest level possiblemdashfor
example activities with business coalitions rather
than individual worksites and with managed care
organizations (MCOs) and state medical associations
rather than individual health care sites or physicians
By working at higher levels to affect systems change
states can impact larger segments of the population
Education and awareness efforts to enhance
public understanding and promote actions related
to cardiovascular diseases and the risk factors of
high blood pressure and high cholesterol signs
and symptoms of heart attack and stroke and the
need to call 9-1-1 are also components of capacity
enhancement
An overarching goal of the State HDSP Program
is to address disparities in heart disease and
stroke and the related risk factors using policy and
systems change strategies Based on disparities
(eg raceethnicity gender geographic geography
socioeconomic status) in mortality access to care
or burden of risk factors the State HDSP Program
should identify Priority Populations and implement
interventions to reach those Priority Populations
No one organization will be able to address the
prevention of heart disease and stroke It will require
many organizations working in collaboration if
progress is to be made in accomplishing the Healthy
People 2010 Objectives Collaboration is defined
by the Wilder Foundation as ldquoa mutually beneficial
and well-defined relationship entered into by two
or more organizations to achieve common goals
The relationship includes a commitment to mutual
relationships and goals a jointly developed structure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
20
and shared responsibility mutual authority and
accountability for success and sharing of resources
and rewardsrdquo Developing and maintaining
strategic partnerships are key to the leveraging of
skills and resources to prevent heart disease and
stroke in a comprehensive way The State HDSP
Program has two major roles related to partners
The first is to convene or facilitate collaboration
to develop and implement a comprehensive state
plan and intervention implementation strategies
that addresses heart disease stroke and related
risk factors The second is to develop strategies to
leverage resources and coordinate interventions
with partners that address the six program
priority areas
A logic model has been developed to describe
the State HDSP Program as intended by the CDC
funding to state health departments (see following
page) The model depicts relationships and actions
(eg links between environment and policy
change and individual-level behavioral change)
that are expected to culminate in reduction in
heart disease and stroke
The CDC and state activities are outlined in terms
of capacity building surveillancemonitoring
and interventions Both CDC and state activities
influence changes that lead to short-term
outcomes such as development of a work plan
and strategies for system-level changes effective
implementation of interventions and action by
target audiences and change agents (those who are
in the position to influence policies and systems
such as hospital administrators and MCO decision
makers) These activities and outcomes result in
changes in policy and environmental supports
which in turn influence behavior changes and
improve health status Ultimately these changes
decrease premature death and disability and
eliminate cardiovascular disparities between
general and Priority Populations
The State HDSP logic model also is a tool to guide
program evaluation By identifying the steps
necessary to reach intended outcomes the logic
model provides guidance in evaluating the short and
intermediate outcomes of the program
State evaluation efforts should relate to the National
HDSP Program logic model or to a logic model that
the state develops that complements the national
model and the required program recipient activities
The logic model can also be seen in the CDC
Evaluation Framework for Heart Disease and Stroke
Prevention State Programs at wwwcdcgovdhdsp
Section 2 National Heart Disease and Stroke Prevention State Program Roles In A Public Health Action Plan to Prevent Heart
Disease and Stroke there are four major goals which
are based on Healthy People 2010
Goal 1 Prevention of risk factors
Goal 2 Detection and treatment of risk factors
Goal 3 Early identification and treatment of heart
attacks and strokes
Goal 4 Prevention of recurrent cardiovascular events
CDC-funded State HDSP Programs have a direct
impact on Goals 2 3 and 4 by addressing HDSP
program priority areas 1ndash6 (see Background section)
HDSP programs have a supportive role with other
state health department programs and partners in
addressing Goal 1 Efforts to address Goal 1 related
to tobacco use diabetes obesity poor nutrition
physical inactivity and schools as a worksite should
be done through a supportive or collaborative role
with the state WISEWOMAN diabetes tobacco
nutrition physical activity or coordinated school
health programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
bull State HDSP Programs are encouraged to
coordinate with other programs in ways that
1 Address Goal 1 (eg State HDSP and Nutrition
Programs identify primary prevention messages
related to cholesterol and salt to be included in Nushy
trition Programs where appropriate State HDSP and
Tobacco Programs collaborate to promote use of
state tobacco quit lines State HDSP Program refers
managed care organizations to materials developed
by the Parks and Recreation Department and
Physical Activity Program on safe places to exercise
National HDSP Program Logic Model
State HDSP and WISEWOMAN Programs collaborate
to create systems for educating health care providers
on guidelines focused on risk factor prevention)
2 Enhance inclusion of key messages in the work
of related programs (eg State HDSP Program
works to implement JNC7 guidelines which
include referral to nutrition counseling the
WISEWOMAN Program incorporates education on
signs and symptoms of heart disease and stroke
into ongoing activities the State HDSP Program
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and system change supports
Level bull State bull Local
Settings bull Community bull Health care bull Worksite
Context bull Priority
Populations bull General
populations
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective intervention
implemented focused on
settings and Priority Populations
Change agents
take action
Activate intended audiences
Capa
city B
uildin
gSu
rveil
lance
Inter
vent
ions
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
21
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
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7
departments in Georgia Massachusetts Michigan
Minnesota Ohio and North Carolina In 2007
CDC The Joint Commissionrsquos Primary Stroke Center
Certification program and the American Heart
AssociationAmerican Stroke Associationrsquos Get With
The Guidelinesreg-Stroke program jointly released a set
of standardized stroke performance measures to be
used by all three programs This effort has reduced
duplication of effort increased collaboration and
encouraged hospitals to participate in the programs
Office of the Director
Mississippi Delta Health Collaborative (Delta Health Initiative)
The Mississippi Delta Health Collaborative (MDHC)
is designed to prevent heart disease stroke and
related chronic diseases Through a new five-year
cooperative agreement this initiative will intensify
collaboration among the Mississippi Department of
Health existing chronic disease programs (eg heart
disease and stroke prevention diabetes tobacco
nutrition physical activity) local health departments
other community health care providers (eg
federally qualified health centers) local communities
and CDC This result will be achieved through
implementation of interventions across Mississippirsquos
18-county Delta Region The program will target
the ldquoABCSrdquo of heart disease and stroke prevention
among priority populations in high burden
underserved rural areas
bull Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
bull Hemoglobin A1c (HbA1c) Monitor and control
blood glucose
bull Blood pressure Prevent and control high blood
pressure
bull Cholesterol Prevent and control high LDL-
cholesterol
bull Smoking Prevent initiation and increase cessation
of smoking and increase the percentage of the
population protected by smoke-free air laws or
regulations
The Mississippi Department of Health will provide
leadership and funding support in the Delta
Region to implement prioritized population-based
interventions policy systems and environmental
change selected as appropriate from a set of
prescribed evidence-based strategies in both the
clinical and community settings
WISEWOMAN
The WISEWOMAN Program began a new five-
year funding cycle June 30 2008 The competitive
application process resulted in 21 programs being
funded This is an increase of six programs from the
previous funding cycle Seventeen WISEWOMAN
programs also receive funding to implement the
National Heart Disease and Stroke Prevention
Program
One major focus of the funding opportunity
announcement (FOA) is development of partnerships
At a minimum funded programs are expected to
partner with their statetribal Breast and Cervical
Cancer Early Detection Program Tobacco Control
Program Heart Disease and Stroke Prevention
ProgramCoalition and other programs that
can affect policies and environments in which
WISEWOMAN participants live work and play
Because the majority of WISEWOMAN funding must
be spent on providing direct services to women
partnerships are extremely important to ensure
participant access to affordable and quality resources
to support heart health
WISEWOMAN evaluation emphasizes program
improvement and is based on the CDC Framework
for Program Evaluation in Public Health CDC has
developed key evaluation questions related to the
programrsquos stated goals and logic model components
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8
The questions are used in the evaluation of the
WISEWOMAN Program Funded programs are
required to conduct evaluations to assess progress
toward meeting stated work plan objectives and to
share results with others including their providers
partners other stakeholders and CDC Funded
programs contribute to the WISEWOMAN Program
evaluation by providing Minimum Data Elements
data submitting information to CDC that supports
program evaluation activities and participating in
activities such as site visits and case studies
Sodium Reduction in Communities
High sodium consumption is a major contributor
to high blood pressure a leading cause of stroke
coronary heart disease heart attack and heart and
kidney failure in the United States The 2010 Dietary
Guidelines for Americans recommend limiting
sodium to less than 2300 milligrams (mg) per day
Individuals who are 51 and older and those of any
age who are African American or have hypertension
diabetes or chronic kidney disease should limit
intake to 1500 mg of sodium per day These groups
account for about half the US population and the
majority of adults
Studies show that on average US adults consume
more than 3400 mg of sodium per day An estimated
77 percent of sodium comes from processed and
restaurant foods Reducing dietary intake of sodium
to 2300 mg per day could prevent as many as 11
million cases of hypertension in the United States
Further reductions in sodium intake to 1500 mg per
day could prevent more than 16 million cases
Through the three-year Sodium Reduction in
Communities cooperative agreement which began in
September 2010 DHDSP is providing support to six
communities to support policy changes designed to
create healthier food environments The communities
receiving support include California (Shasta County)
Kansas (Shawnee County) Los Angeles County
New York City and New York State (Broome and
Schenectady counties)
Program Development and Services Branch
Funded State Programs
National Heart Disease and Stroke Prevention Program The enhanced reach of the National
Heart Disease and Stroke Prevention Program was
a key accomplishment in 2008 Eight new states
(Connecticut Hawaii Idaho Iowa Maryland New
Jersey North Dakota and West Virginia) were funded
as part of the program bringing the total number of
funded programs to 42
Leadership to Center Integration PDSB has
provided leadership to NCCDPHPrsquos initiative to
increase synergy reach and desired health outcomes
in selected NCCDPHP-funded categorical programs
(National Heart Disease and Stroke Prevention
Diabetes Prevention and Control Tobacco Control
Comprehensive Cancer Control Nutrition Physical
Activity and Obesity and the Behavioral Risk Factor
Surveillance System)
National Training DHDSP conducted the 2008
National Heart Disease and Stroke Prevention
Training Institute on September 9ndash11 in Atlanta The
training focused on longer skill-building interactive
workshops that addressed the competencies
program priorities and performance measures of
the FOAs for DHDSPrsquos funded programs It included
the National Heart Disease and Stroke Prevention
Program and WISEWOMAN and was expanded to
include representation from each statersquos heart disease
program as well as American Heart Association
field staff working in the states Informal feedback
indicates that the training has already led to greater
collaboration at the state level
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9
Management Information System (MIS) In 2008
DHDSP completed revisions for the heart disease
and stroke prevention Web-based MIS The report
generated by the system was changed to a table that
displays an objective time frame status and progress
in an easy-to-read format These changes made the
system more user friendly for states and CDC The
MIS can now be used to
bull Describe state program activities and expected
use of CDC funds
bull Track progress on state program activities and
identify promising practices
bull Assist CDC in identifying the need for training
and technical assistance
bull Standardize the state reporting process to
facilitate evaluation
bull Enable CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Funded Partnerships
Directors of Health Promotion and Education
(DHPE) In 2008 DHDSP continued to support
the DHPECDC Internship Program for Students
of Minority Serving Institutions
National Stroke Association DHDSP assisted with
funding for the Sixth Annual National Public Health
Stroke Summit conducted by the National Stroke
Association in Denver Colorado in December 2007
The Summit brought together 105 state public health
and health care professionals to promote information
sharing knowledge and skill building networking
and partnership development
National Collaborations
Cardiovascular Health (CVH) Council of the National Association of Chronic Disease Directors (NACDD) In 2008 the CVH Council
updated its section of the NACDD website to include
additional materials useful to states and it started
a Web discussion forum that allows states to share
ideas and products The Council obtained private
funds and sponsored the 2-day Northeast Regional
Workshop on Cholesterol Control in which 11
states participated in May 2008 It also funded two
of the participating states (Maine and Maryland)
to do follow-up work on cholesterol control with
their primary care associations and local federally
qualified health centers In March 2008 the
Council led the development of a themed issue of
the e-journal Preventing Chronic Disease In most
cases state program staff coauthored articles with
DHDSP staff The CVH Council worked with DHDSP
to assess the training needs of state programs in
the National Heart Disease and Stroke Prevention
Program and DHDSP used this information to plan
its September 2008 3-day training workshop for state
program and WISEWOMAN staff
Epidemiology and Surveillance Branch
Cardiac Arrest Registry to Enhance Survival
The Cardiac Arrest Registry to Enhance Survival
(CARES) began in 2005 in Atlanta and has since
expanded to 40 communities in 23 states CARES is
a simple but robust registry of cardiac arrest events
that allows participating sites to enter data related
to out-of-hospital cardiac arrest (OHCA) generate
summary reports and compare local data with
similar EMS systems elsewhere Three sources of
data are linked to describe each OHCA event 1)
9-1-1 call center data (to provide incident address
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10
and dispatch and arrival times) 2) EMS data (to
describe initially recorded cardiac rhythm and
treatment methods) and 3) hospital data (emergency
department and hospital outcome hypothermia
treatment and neurologic status at discharge)
Multiple reporting features can be generated and
monitored continuously through secure online access
by CARES participants which allows for longitudinal
internal benchmarking Local EMS administrators
and medical directors are able to identify when and
where cardiac arrests occur which elements of their
EMS system are functioning properly in dealing
with these cases and what changes can be made to
improve outcomes In 2011 CARES began expanding
to statewide participation in six states which will
allow additional communities of different sizes and
population densities to be included in the registry In
addition state-level participation will promote better
communication and collaboration between state and
local EMS providers A recent MMWR Surveillance
Summary was published summarizing CARES data
collected during October 1 2005ndashDecember 31
2010 (wwwcdcgovmmwrpdfssss6008pdf) More
information about CARES can be found on the
CARES website at httpsmycaresnet
Paul Coverdell National Acute Stroke Registry
New Registries The Paul Coverdell National
Acute Stroke Registry program successfully
implemented stroke registries in three newly
funded states in 2007 (Michigan Minnesota and
Ohio) These states made much greater progress
in their first year toward developing program
infrastructure collecting data and engaging in
quality improvement activities than had the four
states that completed their first year of Coverdell
Registry funding in 2004 Much of this progress can
be attributed to CDCrsquos increased capacity to provide
proactive technical assistance to states through
conference calls work groups and resource
materials such as the program resource manual
Supplemental Projects The Coverdell Registry
team developed and funded a supplemental
cooperative agreement to pilot the expansion of
the Coverdell Registry model to other domains
within stroke systems of care North Carolina was
funded to demonstrate the feasibility of linking
pre-hospital EMS data for stroke with the state
Coverdell Registry (the North Carolina Stroke
Care Collaborative) In 2010 in partnership with
the Association of State and Territorial Health
Officials CDC funded two Coverdell states to
develop comprehensive statewide stroke care
systems plans CDC is currently funding the Ohio
Coverdell Registry to study 30-day outcomes
of stroke patients based on the quality of care
provided In partnership with the Agency for
Healthcare Research and Quality CDC has funded
an evidence-based review of transitions in care
from hospital to home or rehabilitation for stroke
patients
National Evaluation Plan Through a yearlong
collaboration with RTI International the Coverdell
Registry developed a national evaluation plan The
plan provides a systematic method of assessing
the annual and long-term performance of the
program including strategic goals and objectives
performance goals performance measures and
targets for program outcomes
Consensus Stroke Performance Measures
Endorsement of the Consensus Stroke
Performance Measures The Coverdell Registry
partnered with the American Heart Association
and The Joint Commission to develop performance
measures for acute stroke care commonly
referred to as the Consensus Stroke Performance
Measures These measures were released to
hospitals throughout the United States in fall
2007 In January 2008 more than 1200 hospitals
began using these measures to improve the quality
of care for acute stroke patients The measures
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11
were submitted to the National Quality Forum in
March 2008 and 8 of the 10 were adopted This
endorsement of the Consensus Stroke Performance
Measures has paved the way for adoption of
these measures by the Centers for Medicare
and Medicaid Services for quality reporting and
meaningful use
Quarterly Data Reports With the implementation
of the Consensus Stroke Performance Measures in
January 2008 CDC began providing states with
quarterly data reports on the measures These
reports provide each state with a summary of its
data on ischemic stroke hemorrhagic stroke and
transient ischemic attacks as well as aggregate data
for all states in the Coverdell Registry program
Applied Research and Evaluation Branch
Building an Economic Evaluation Research Agenda
Based on program needs and research gaps in heart
disease and stroke prevention the Applied Research
and Evaluation Branch developed an agenda to
guide economic research on 1) economic burden
of cardiovascular diseases and cost-effectiveness of
their control 2) economic value of DHDSP-funded
and other state prevention programs 3) CDCrsquos
Internet-based clearinghouse for information on
the economics of cardiovascular diseases and 4)
developing partnerships in economic research to
increase the impact of such research
Stroke Awareness Signs and Symptoms Awareness Campaigns
To provide guidance for state programs a review of
current research on stroke awareness campaigns was
undertaken to identify evidence to support the most
appropriate ways to increase knowledge of signs and
symptoms for stroke the importance of calling 9-1-1
and relationships between the educational campaigns
and outcomes related to awareness of stroke signs
and symptoms
The literature review and synthesis of current
research on stroke awareness campaigns resulted
in the following dissemination activities
bull Development of a fact sheet for state programs on
literature review findings and considerations for
statesrsquo current activities related to stroke awareness
messages including direct education and tools
available to facilitate campaign development
bull Poster presentation at the 2008 National
Conference on Health Communication Marketing
and Media on evaluation guidance for stroke
awareness campaigns The presentation outlined
specific information for states and communities on
how to strengthen the effectiveness and outcome
evaluation of their stroke awareness campaigns
bull Presentation at the 2008 National Heart Disease
and Stroke Prevention Training Institute about
evidence and research on communication and
media campaigns impact considerations of cost
opportunities for partnering and evaluating
results
Comprehensive and Core Indicators
DHDSP released a set of core indicators for
hypertension as part of a comprehensive evidence-
based set of indicators to guide state heart disease
and stroke prevention programs in evaluating their
efforts State health departments received related
key guidance documents training at the National
Heart Disease and Stroke Prevention Training
Institute and a series of follow-up trainings
Indicators are presented in a Consumer Reports
format and rated on multiple dimensions such as
strength of scientific evidence feasibility of data
collection and face validity
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12
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkitmdash Evaluation Results
CDC worked with the American Institutes for
Research (AIR) to conduct an evaluation of the
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit State health departments
(SHDs) were trained to use the toolkit to promote
state employer-based initiatives on workplace efforts
for heart disease and stroke prevention
From 2005 to 2007 all the SHDs received copies of
the toolkit and were invited to attend training sessions
(one seminar five webinars and three consultations)
To evaluate the usefulness of the toolkit materials
and obtain recommendations two focus groups with
business leaders and Web-based surveys of the SHDs
were conducted In 2006 all 50 states and the District
of Columbia completed the baseline and in 2008 40
states completed the follow-up
Of the 40 SHDs that completed both waves of the
survey the proportion that reported engaging in
employer-based initiatives significantly increased
from 65 percent to 725 percent during the period
examined despite a reported reduction in staff and
limited appropriations About 90 percent of the
SHDs that responded to the 2008 survey are now
working with employers to promote comprehensive
heart disease and stroke prevention programs
disseminate best practices establish employer-
oriented partnerships participate in seminars for
employers and provide business leaders with
resources Partnerships with employer groups or
business coalitions have focused on worksite policy
changes health promotion and education and
worksite surveillance and assessments In parallel
to these experiences the SHDs have increased their
overall level of confidence in their knowledge and
skills Most of the SHDs (61 percent) agreed that
the CDC trainings and consultations helped them
improve their heart disease and stroke prevention
programs and use the toolkit more effectively
Participation in the trainings was positively associated
with engagement in worksite health promotion and
education The SHDs that received federal funding
had significantly higher participation in macro-
marketing activities reaching employers through
business coalitions associations task forces and
champions and were more likely to establish
partnerships with employer groups and government
agencies
The Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit is available at wwwcdc
govdhdsplibrarytoolkitindexhtm
The Branch also provides economics support to
the Division and partners by documenting costs of
cardiovascular diseases and their risk factors and
identifying cost-effective interventions
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13
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
National Heart Disease and Stroke Prevention Program Overview
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
14
u Blood pressure Prevent and control high blood Program Overview pressure reduce sodium intake
bull In 1998 the US Congress provided funding
for CDC to initiate a national state-based Heart
Disease and Stroke Prevention (HDSP) program in
eight states
bull CDC funds programs in 41 states and the
District of Columbia Twenty-eight are capacity
building (planning) programs and 14 are basic
implementation (intervention) programs
bull Capacity Building Programs Alabama
Alaska Arizona California Colorado Connecticut
District of Columbia Hawaii Idaho Illinois Iowa
Kansas Kentucky Louisiana Maryland Michigan
Minnesota Mississippi Nebraska New Jersey
North Dakota Ohio Oklahoma Oregon Rhode
Island Tennessee Texas and Wisconsin
bull Basic Implementation Programs Arkansas
Florida Georgia Maine Massachusetts Missouri
Montana New York North Carolina South
Carolina Utah Virginia Washington and West
Virginia
National Heart Disease and Stroke Prevention Program Goals bull Enhance state capacity to plan implement track
and sustain population-based interventions to
address heart disease stroke and related risk
factors Focus program efforts on population-
based policy and systems change strategies to
impact the ldquoABCSrdquo of heart disease and stroke
prevention
u Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
u Cholesterol Prevent and control high
cholesterol
u Smoking Increase the number of smokers
counseled to quit and referred to quitlines by
health care workers increase availability of no
or low-cost cessation products and collaborate
with efforts to increase the percentage of the
population protected by smoke-free air laws
and regulations
To a lesser extent state HDSP programs work to
improve emergency response and quality of acute
care systems
State HDSP programs work to eliminate health
disparities in priority populations (ie groups with
increased burden or need based on race ethnicity
gender geography or socioeconomic status) as an
overarching principle
bull Collaborate with chronic disease programs (eg
those focusing on tobacco diabetes physical
inactivity poor nutrition and obesityoverweight)
and partners to develop and integrate population-
based strategies to prevent heart disease and
stroke
bull Promote cardiovascular health in health care
worksite and community settings through policy
and systems changes
bull Identify and evaluate promising practices to
address heart disease and stroke
bull Conduct surveillance of heart disease stroke
and related risk factors
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
15
u
u
Key Responsibilities of State Capacity Building Programs bull Facilitate collaboration with public- and private-
sector partners such as not-for-profit health
agencies health systems organizations emergency
response agencies federally funded health centers
businesses priority population organizations and
voluntary health organizations
bull Document the state burden of heart disease
stroke and related risk factors
bull Develop plans for population-based strategies
for preventing heart disease and stroke among
general and Priority Populations
bull Develop a comprehensive state HDSP plan
bull Develop an HDSP program logic model and
evaluation plan
bull Assess assets and gaps in state policy and systems
related to HDSP in health care worksite and
community settings
Key Responsibilities of State Basic Implementation Programs bull Enhance all capacity-building program activities
bull Implement and evaluate policy systems change
and educational interventions that address the
six HDSP program priority areas in health care
worksite and community settings
bull Provide training and technical assistance to
public health and health care professionals and
partners to support policy and system changes
that will encourage heart disease and stroke
prevention
How CDC Assists State Heart Disease and Stroke Prevention Programs bull Provides training technical assistance and
funding
bull Funds applied research on heart disease and
stroke interventions and elimination of disparities
that is relevant to state programs
bull Identifies and disseminates science-based
promising practices
bull Partners with national organizations to help states
address prevention of heart disease and stroke
bull Facilitates collaborations with other state chronic
disease programs or activities that address risk
factors populations or settings related to heart
disease and stroke prevention and program
priority areas
bull Develops and disseminates publications and tools
such as
u CDCynergy a CD-ROM-based tool for
planning health communication interventions
State Heart Disease and Stroke Prevention
Program Evaluation Framework (wwwcdc
govdhdsplibraryevaluation_framework
indexhtm) a document providing guidance
on systematic ways to measure the success of
public health programs and on logic model
development
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping an
Evaluation Plan (wwwcdcgovDHDSPstate_
programevaluation_guidesevaluation_plan
htm) a document providing guidance on the
development of evaluation activities to help
programs identify required staff time and
resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
16
u
u
u
u
u
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping and
Using a Logic Model (wwwcdcgovDHDSP
state_programevaluation_guideslogic_model
htm) a document providing guidance on
the development and use of logic models as
planning and evaluation tools
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashWriting SMART
Objectives (wwwcdcgovDHDSPstate_
programevaluation_guidessmart_objectives
htm) a document providing guidance to
states on the development of realistic and
measurable objectives
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit (wwwcdcgov
dhdsplibrarytoolkitindexhtm) a document
that provides information materials and
tools that state programs can reference and
distribute to businesses primarily through
employer and professional organizations
Heart Disease and Stroke Interactive Maps
(wwwcdcgovdhdsplibrarymapsstatemaps
htm) which present heart disease and stroke
mortality rates by county for the state racial
ethnic group and gender of the userrsquos choice
A Communication Guide for Policy and
Environmental Change (wwwcdcgovdhdsp
libraryheart_stroke_guideindexhtm) which
includes information references and examples
of communication from state programs and
Stroke Addendum to the Communication
Guide (wwwcdcgovdhdsplibraryheart_
stroke_guideindexhtm)
For additional information please visit the CDC
website at wwwcdcgovdhdsp or contact the
Division for Heart Disease and Stroke Prevention
Program Development and Services Branch at
(770) 488-2424
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
17
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
State Heart Disease and Stroke Prevention Program Funding Opportunity Announcement DP07-704 At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
18
Introduction The Funding Opportunity Announcement
(FOA) DP07-704 At-A-Glance provides important
information to assist programs funded under this
announcement to deliver their program as intended
The At-A-Glance highlights aspects of FOA DP07-704
important for all funded programs including
the following
bull Overview of the National Heart Disease and
Stroke Prevention Program
bull Heart Disease and Stroke Prevention State
Program roles
bull Performance measures for Capacity Building Basic
Implementation Optional Funding for Capacity
Building programs and Stroke Networks
bull Funded program reporting requirements
bull Budgetfunding guidance
bull National and administrative policy requirements
If a program needs a copy of the full document
it should contact its project officer (see Program
Contacts section of the full National Heart Disease
and Stroke Prevention Program Staff Orientation
Manual) to fulfill that request
Section 1 Background In 1998 the US Congress provided funding for
CDC to initiate a national state-based cardiovascular
health program The Senate Appropriations
Committee in 2005 encouraged CDC to create the
Division for Heart Disease and Stroke Prevention and
increased resources enabling CDC to reach 32 of the
50 states and the District of Columbia with funding
for heart disease and stroke prevention As of 2008
the Heart Disease and Stroke Prevention (HDSP)
program funds 41 states and the District of Columbia
As the Division for Heart Disease and Stroke
Prevention developed so did the focus of the State
HDSP Program Focusing on the six program priority
areas (noted below) should impact morbidity and
mortality of these diseases State programs should
increase heart disease and stroke prevention policies
and systems change with the potential to impact
the general population and Priority Populations
(see Prevention Works CDC Strategies for a Heart-
healthy and Stroke-free America wwwCDCgov
dhdsplibrary) For more information on the CDC
State HDSP Program visit wwwcdcgovdhdspState_
programindexhtm
A Public Health Action Plan to Prevent Heart Disease
and Stroke (see wwwCDCgovdhdsplibrary)
documents the multiple intervention opportunities
for preventing heart disease and stroke It is
important to work with partners collaboratively in
leveraging resources to address the multiple risk
factors that are associated with these diseases
Announcement DP07-704 supports program
components considered essential to enhancing
the leadership of state health departments in
heart disease and stroke prevention It provides
for the funding of capacity building and basic
implementation programs as well as projects such as
the Optional Funding for Capacity Building Programs
and Stroke Networks
A capacity building program develops the foundation
for a comprehensive cardiovascular disease prevention
program through such activities as partnership
development definition of the burden and
development of a state plan A basic implementation
program enhances capacity building activities and
implements disseminates and evaluates intervention
activities that address the state plan objectives and the
CDC program priority areas 1ndash6
1 Increase control of high blood pressure primarily
in adults and older adults
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
19
2 Increase control of high blood cholesterol
primarily in adults and older adults
3 Increase knowledge of signs and symptoms for
heart attack and stroke and the importance of
calling 9-1-1
4 Improve emergency response
5 Improve quality of heart disease and stroke care
6 Eliminate disparities in terms of race ethnicity
gender geography or socioeconomic status
Optional Funding for Capacity Building Programs
provides support to programs to implement an
evidence-based or promising practice demonstration
project that addresses the CDC program priority
areas 1ndash6
Stroke Networks support a state health department to
increase stroke prevention activities across a group of
three to six contiguous member states with emphasis
on increasing awareness and implementing priority
policy or systems changes across the states
The State HDSP Program is anchored on the
framework of the Socio-ecological Model which
conceptualized the influences of individual
behaviors family and social relationships community
and environmental effects and societal influences
such as policies on health status In order to
promote significant impact for improving the health
of the population interventions should focus on
implementing policy and systems change strategies
that support heart disease and stroke prevention
Policy change can be addressed through a) public
policy (eg establishing certification for hospital-
based stroke centers) or b) organizational policy
(eg businesses providing health benefits plans
that cover preventive services that include blood
pressure control)
System changes are encouraged in three settings
worksites health care and communities An
example of a systems change is when a health
care setting implements electronic records and
patient care management systems that improve the
quality of health care Interventions within systems
are encouraged at the highest level possiblemdashfor
example activities with business coalitions rather
than individual worksites and with managed care
organizations (MCOs) and state medical associations
rather than individual health care sites or physicians
By working at higher levels to affect systems change
states can impact larger segments of the population
Education and awareness efforts to enhance
public understanding and promote actions related
to cardiovascular diseases and the risk factors of
high blood pressure and high cholesterol signs
and symptoms of heart attack and stroke and the
need to call 9-1-1 are also components of capacity
enhancement
An overarching goal of the State HDSP Program
is to address disparities in heart disease and
stroke and the related risk factors using policy and
systems change strategies Based on disparities
(eg raceethnicity gender geographic geography
socioeconomic status) in mortality access to care
or burden of risk factors the State HDSP Program
should identify Priority Populations and implement
interventions to reach those Priority Populations
No one organization will be able to address the
prevention of heart disease and stroke It will require
many organizations working in collaboration if
progress is to be made in accomplishing the Healthy
People 2010 Objectives Collaboration is defined
by the Wilder Foundation as ldquoa mutually beneficial
and well-defined relationship entered into by two
or more organizations to achieve common goals
The relationship includes a commitment to mutual
relationships and goals a jointly developed structure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
20
and shared responsibility mutual authority and
accountability for success and sharing of resources
and rewardsrdquo Developing and maintaining
strategic partnerships are key to the leveraging of
skills and resources to prevent heart disease and
stroke in a comprehensive way The State HDSP
Program has two major roles related to partners
The first is to convene or facilitate collaboration
to develop and implement a comprehensive state
plan and intervention implementation strategies
that addresses heart disease stroke and related
risk factors The second is to develop strategies to
leverage resources and coordinate interventions
with partners that address the six program
priority areas
A logic model has been developed to describe
the State HDSP Program as intended by the CDC
funding to state health departments (see following
page) The model depicts relationships and actions
(eg links between environment and policy
change and individual-level behavioral change)
that are expected to culminate in reduction in
heart disease and stroke
The CDC and state activities are outlined in terms
of capacity building surveillancemonitoring
and interventions Both CDC and state activities
influence changes that lead to short-term
outcomes such as development of a work plan
and strategies for system-level changes effective
implementation of interventions and action by
target audiences and change agents (those who are
in the position to influence policies and systems
such as hospital administrators and MCO decision
makers) These activities and outcomes result in
changes in policy and environmental supports
which in turn influence behavior changes and
improve health status Ultimately these changes
decrease premature death and disability and
eliminate cardiovascular disparities between
general and Priority Populations
The State HDSP logic model also is a tool to guide
program evaluation By identifying the steps
necessary to reach intended outcomes the logic
model provides guidance in evaluating the short and
intermediate outcomes of the program
State evaluation efforts should relate to the National
HDSP Program logic model or to a logic model that
the state develops that complements the national
model and the required program recipient activities
The logic model can also be seen in the CDC
Evaluation Framework for Heart Disease and Stroke
Prevention State Programs at wwwcdcgovdhdsp
Section 2 National Heart Disease and Stroke Prevention State Program Roles In A Public Health Action Plan to Prevent Heart
Disease and Stroke there are four major goals which
are based on Healthy People 2010
Goal 1 Prevention of risk factors
Goal 2 Detection and treatment of risk factors
Goal 3 Early identification and treatment of heart
attacks and strokes
Goal 4 Prevention of recurrent cardiovascular events
CDC-funded State HDSP Programs have a direct
impact on Goals 2 3 and 4 by addressing HDSP
program priority areas 1ndash6 (see Background section)
HDSP programs have a supportive role with other
state health department programs and partners in
addressing Goal 1 Efforts to address Goal 1 related
to tobacco use diabetes obesity poor nutrition
physical inactivity and schools as a worksite should
be done through a supportive or collaborative role
with the state WISEWOMAN diabetes tobacco
nutrition physical activity or coordinated school
health programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
bull State HDSP Programs are encouraged to
coordinate with other programs in ways that
1 Address Goal 1 (eg State HDSP and Nutrition
Programs identify primary prevention messages
related to cholesterol and salt to be included in Nushy
trition Programs where appropriate State HDSP and
Tobacco Programs collaborate to promote use of
state tobacco quit lines State HDSP Program refers
managed care organizations to materials developed
by the Parks and Recreation Department and
Physical Activity Program on safe places to exercise
National HDSP Program Logic Model
State HDSP and WISEWOMAN Programs collaborate
to create systems for educating health care providers
on guidelines focused on risk factor prevention)
2 Enhance inclusion of key messages in the work
of related programs (eg State HDSP Program
works to implement JNC7 guidelines which
include referral to nutrition counseling the
WISEWOMAN Program incorporates education on
signs and symptoms of heart disease and stroke
into ongoing activities the State HDSP Program
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and system change supports
Level bull State bull Local
Settings bull Community bull Health care bull Worksite
Context bull Priority
Populations bull General
populations
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective intervention
implemented focused on
settings and Priority Populations
Change agents
take action
Activate intended audiences
Capa
city B
uildin
gSu
rveil
lance
Inter
vent
ions
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
21
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
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55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
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56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
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8
The questions are used in the evaluation of the
WISEWOMAN Program Funded programs are
required to conduct evaluations to assess progress
toward meeting stated work plan objectives and to
share results with others including their providers
partners other stakeholders and CDC Funded
programs contribute to the WISEWOMAN Program
evaluation by providing Minimum Data Elements
data submitting information to CDC that supports
program evaluation activities and participating in
activities such as site visits and case studies
Sodium Reduction in Communities
High sodium consumption is a major contributor
to high blood pressure a leading cause of stroke
coronary heart disease heart attack and heart and
kidney failure in the United States The 2010 Dietary
Guidelines for Americans recommend limiting
sodium to less than 2300 milligrams (mg) per day
Individuals who are 51 and older and those of any
age who are African American or have hypertension
diabetes or chronic kidney disease should limit
intake to 1500 mg of sodium per day These groups
account for about half the US population and the
majority of adults
Studies show that on average US adults consume
more than 3400 mg of sodium per day An estimated
77 percent of sodium comes from processed and
restaurant foods Reducing dietary intake of sodium
to 2300 mg per day could prevent as many as 11
million cases of hypertension in the United States
Further reductions in sodium intake to 1500 mg per
day could prevent more than 16 million cases
Through the three-year Sodium Reduction in
Communities cooperative agreement which began in
September 2010 DHDSP is providing support to six
communities to support policy changes designed to
create healthier food environments The communities
receiving support include California (Shasta County)
Kansas (Shawnee County) Los Angeles County
New York City and New York State (Broome and
Schenectady counties)
Program Development and Services Branch
Funded State Programs
National Heart Disease and Stroke Prevention Program The enhanced reach of the National
Heart Disease and Stroke Prevention Program was
a key accomplishment in 2008 Eight new states
(Connecticut Hawaii Idaho Iowa Maryland New
Jersey North Dakota and West Virginia) were funded
as part of the program bringing the total number of
funded programs to 42
Leadership to Center Integration PDSB has
provided leadership to NCCDPHPrsquos initiative to
increase synergy reach and desired health outcomes
in selected NCCDPHP-funded categorical programs
(National Heart Disease and Stroke Prevention
Diabetes Prevention and Control Tobacco Control
Comprehensive Cancer Control Nutrition Physical
Activity and Obesity and the Behavioral Risk Factor
Surveillance System)
National Training DHDSP conducted the 2008
National Heart Disease and Stroke Prevention
Training Institute on September 9ndash11 in Atlanta The
training focused on longer skill-building interactive
workshops that addressed the competencies
program priorities and performance measures of
the FOAs for DHDSPrsquos funded programs It included
the National Heart Disease and Stroke Prevention
Program and WISEWOMAN and was expanded to
include representation from each statersquos heart disease
program as well as American Heart Association
field staff working in the states Informal feedback
indicates that the training has already led to greater
collaboration at the state level
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9
Management Information System (MIS) In 2008
DHDSP completed revisions for the heart disease
and stroke prevention Web-based MIS The report
generated by the system was changed to a table that
displays an objective time frame status and progress
in an easy-to-read format These changes made the
system more user friendly for states and CDC The
MIS can now be used to
bull Describe state program activities and expected
use of CDC funds
bull Track progress on state program activities and
identify promising practices
bull Assist CDC in identifying the need for training
and technical assistance
bull Standardize the state reporting process to
facilitate evaluation
bull Enable CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Funded Partnerships
Directors of Health Promotion and Education
(DHPE) In 2008 DHDSP continued to support
the DHPECDC Internship Program for Students
of Minority Serving Institutions
National Stroke Association DHDSP assisted with
funding for the Sixth Annual National Public Health
Stroke Summit conducted by the National Stroke
Association in Denver Colorado in December 2007
The Summit brought together 105 state public health
and health care professionals to promote information
sharing knowledge and skill building networking
and partnership development
National Collaborations
Cardiovascular Health (CVH) Council of the National Association of Chronic Disease Directors (NACDD) In 2008 the CVH Council
updated its section of the NACDD website to include
additional materials useful to states and it started
a Web discussion forum that allows states to share
ideas and products The Council obtained private
funds and sponsored the 2-day Northeast Regional
Workshop on Cholesterol Control in which 11
states participated in May 2008 It also funded two
of the participating states (Maine and Maryland)
to do follow-up work on cholesterol control with
their primary care associations and local federally
qualified health centers In March 2008 the
Council led the development of a themed issue of
the e-journal Preventing Chronic Disease In most
cases state program staff coauthored articles with
DHDSP staff The CVH Council worked with DHDSP
to assess the training needs of state programs in
the National Heart Disease and Stroke Prevention
Program and DHDSP used this information to plan
its September 2008 3-day training workshop for state
program and WISEWOMAN staff
Epidemiology and Surveillance Branch
Cardiac Arrest Registry to Enhance Survival
The Cardiac Arrest Registry to Enhance Survival
(CARES) began in 2005 in Atlanta and has since
expanded to 40 communities in 23 states CARES is
a simple but robust registry of cardiac arrest events
that allows participating sites to enter data related
to out-of-hospital cardiac arrest (OHCA) generate
summary reports and compare local data with
similar EMS systems elsewhere Three sources of
data are linked to describe each OHCA event 1)
9-1-1 call center data (to provide incident address
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10
and dispatch and arrival times) 2) EMS data (to
describe initially recorded cardiac rhythm and
treatment methods) and 3) hospital data (emergency
department and hospital outcome hypothermia
treatment and neurologic status at discharge)
Multiple reporting features can be generated and
monitored continuously through secure online access
by CARES participants which allows for longitudinal
internal benchmarking Local EMS administrators
and medical directors are able to identify when and
where cardiac arrests occur which elements of their
EMS system are functioning properly in dealing
with these cases and what changes can be made to
improve outcomes In 2011 CARES began expanding
to statewide participation in six states which will
allow additional communities of different sizes and
population densities to be included in the registry In
addition state-level participation will promote better
communication and collaboration between state and
local EMS providers A recent MMWR Surveillance
Summary was published summarizing CARES data
collected during October 1 2005ndashDecember 31
2010 (wwwcdcgovmmwrpdfssss6008pdf) More
information about CARES can be found on the
CARES website at httpsmycaresnet
Paul Coverdell National Acute Stroke Registry
New Registries The Paul Coverdell National
Acute Stroke Registry program successfully
implemented stroke registries in three newly
funded states in 2007 (Michigan Minnesota and
Ohio) These states made much greater progress
in their first year toward developing program
infrastructure collecting data and engaging in
quality improvement activities than had the four
states that completed their first year of Coverdell
Registry funding in 2004 Much of this progress can
be attributed to CDCrsquos increased capacity to provide
proactive technical assistance to states through
conference calls work groups and resource
materials such as the program resource manual
Supplemental Projects The Coverdell Registry
team developed and funded a supplemental
cooperative agreement to pilot the expansion of
the Coverdell Registry model to other domains
within stroke systems of care North Carolina was
funded to demonstrate the feasibility of linking
pre-hospital EMS data for stroke with the state
Coverdell Registry (the North Carolina Stroke
Care Collaborative) In 2010 in partnership with
the Association of State and Territorial Health
Officials CDC funded two Coverdell states to
develop comprehensive statewide stroke care
systems plans CDC is currently funding the Ohio
Coverdell Registry to study 30-day outcomes
of stroke patients based on the quality of care
provided In partnership with the Agency for
Healthcare Research and Quality CDC has funded
an evidence-based review of transitions in care
from hospital to home or rehabilitation for stroke
patients
National Evaluation Plan Through a yearlong
collaboration with RTI International the Coverdell
Registry developed a national evaluation plan The
plan provides a systematic method of assessing
the annual and long-term performance of the
program including strategic goals and objectives
performance goals performance measures and
targets for program outcomes
Consensus Stroke Performance Measures
Endorsement of the Consensus Stroke
Performance Measures The Coverdell Registry
partnered with the American Heart Association
and The Joint Commission to develop performance
measures for acute stroke care commonly
referred to as the Consensus Stroke Performance
Measures These measures were released to
hospitals throughout the United States in fall
2007 In January 2008 more than 1200 hospitals
began using these measures to improve the quality
of care for acute stroke patients The measures
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
11
were submitted to the National Quality Forum in
March 2008 and 8 of the 10 were adopted This
endorsement of the Consensus Stroke Performance
Measures has paved the way for adoption of
these measures by the Centers for Medicare
and Medicaid Services for quality reporting and
meaningful use
Quarterly Data Reports With the implementation
of the Consensus Stroke Performance Measures in
January 2008 CDC began providing states with
quarterly data reports on the measures These
reports provide each state with a summary of its
data on ischemic stroke hemorrhagic stroke and
transient ischemic attacks as well as aggregate data
for all states in the Coverdell Registry program
Applied Research and Evaluation Branch
Building an Economic Evaluation Research Agenda
Based on program needs and research gaps in heart
disease and stroke prevention the Applied Research
and Evaluation Branch developed an agenda to
guide economic research on 1) economic burden
of cardiovascular diseases and cost-effectiveness of
their control 2) economic value of DHDSP-funded
and other state prevention programs 3) CDCrsquos
Internet-based clearinghouse for information on
the economics of cardiovascular diseases and 4)
developing partnerships in economic research to
increase the impact of such research
Stroke Awareness Signs and Symptoms Awareness Campaigns
To provide guidance for state programs a review of
current research on stroke awareness campaigns was
undertaken to identify evidence to support the most
appropriate ways to increase knowledge of signs and
symptoms for stroke the importance of calling 9-1-1
and relationships between the educational campaigns
and outcomes related to awareness of stroke signs
and symptoms
The literature review and synthesis of current
research on stroke awareness campaigns resulted
in the following dissemination activities
bull Development of a fact sheet for state programs on
literature review findings and considerations for
statesrsquo current activities related to stroke awareness
messages including direct education and tools
available to facilitate campaign development
bull Poster presentation at the 2008 National
Conference on Health Communication Marketing
and Media on evaluation guidance for stroke
awareness campaigns The presentation outlined
specific information for states and communities on
how to strengthen the effectiveness and outcome
evaluation of their stroke awareness campaigns
bull Presentation at the 2008 National Heart Disease
and Stroke Prevention Training Institute about
evidence and research on communication and
media campaigns impact considerations of cost
opportunities for partnering and evaluating
results
Comprehensive and Core Indicators
DHDSP released a set of core indicators for
hypertension as part of a comprehensive evidence-
based set of indicators to guide state heart disease
and stroke prevention programs in evaluating their
efforts State health departments received related
key guidance documents training at the National
Heart Disease and Stroke Prevention Training
Institute and a series of follow-up trainings
Indicators are presented in a Consumer Reports
format and rated on multiple dimensions such as
strength of scientific evidence feasibility of data
collection and face validity
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
12
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkitmdash Evaluation Results
CDC worked with the American Institutes for
Research (AIR) to conduct an evaluation of the
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit State health departments
(SHDs) were trained to use the toolkit to promote
state employer-based initiatives on workplace efforts
for heart disease and stroke prevention
From 2005 to 2007 all the SHDs received copies of
the toolkit and were invited to attend training sessions
(one seminar five webinars and three consultations)
To evaluate the usefulness of the toolkit materials
and obtain recommendations two focus groups with
business leaders and Web-based surveys of the SHDs
were conducted In 2006 all 50 states and the District
of Columbia completed the baseline and in 2008 40
states completed the follow-up
Of the 40 SHDs that completed both waves of the
survey the proportion that reported engaging in
employer-based initiatives significantly increased
from 65 percent to 725 percent during the period
examined despite a reported reduction in staff and
limited appropriations About 90 percent of the
SHDs that responded to the 2008 survey are now
working with employers to promote comprehensive
heart disease and stroke prevention programs
disseminate best practices establish employer-
oriented partnerships participate in seminars for
employers and provide business leaders with
resources Partnerships with employer groups or
business coalitions have focused on worksite policy
changes health promotion and education and
worksite surveillance and assessments In parallel
to these experiences the SHDs have increased their
overall level of confidence in their knowledge and
skills Most of the SHDs (61 percent) agreed that
the CDC trainings and consultations helped them
improve their heart disease and stroke prevention
programs and use the toolkit more effectively
Participation in the trainings was positively associated
with engagement in worksite health promotion and
education The SHDs that received federal funding
had significantly higher participation in macro-
marketing activities reaching employers through
business coalitions associations task forces and
champions and were more likely to establish
partnerships with employer groups and government
agencies
The Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit is available at wwwcdc
govdhdsplibrarytoolkitindexhtm
The Branch also provides economics support to
the Division and partners by documenting costs of
cardiovascular diseases and their risk factors and
identifying cost-effective interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
13
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
National Heart Disease and Stroke Prevention Program Overview
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
14
u Blood pressure Prevent and control high blood Program Overview pressure reduce sodium intake
bull In 1998 the US Congress provided funding
for CDC to initiate a national state-based Heart
Disease and Stroke Prevention (HDSP) program in
eight states
bull CDC funds programs in 41 states and the
District of Columbia Twenty-eight are capacity
building (planning) programs and 14 are basic
implementation (intervention) programs
bull Capacity Building Programs Alabama
Alaska Arizona California Colorado Connecticut
District of Columbia Hawaii Idaho Illinois Iowa
Kansas Kentucky Louisiana Maryland Michigan
Minnesota Mississippi Nebraska New Jersey
North Dakota Ohio Oklahoma Oregon Rhode
Island Tennessee Texas and Wisconsin
bull Basic Implementation Programs Arkansas
Florida Georgia Maine Massachusetts Missouri
Montana New York North Carolina South
Carolina Utah Virginia Washington and West
Virginia
National Heart Disease and Stroke Prevention Program Goals bull Enhance state capacity to plan implement track
and sustain population-based interventions to
address heart disease stroke and related risk
factors Focus program efforts on population-
based policy and systems change strategies to
impact the ldquoABCSrdquo of heart disease and stroke
prevention
u Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
u Cholesterol Prevent and control high
cholesterol
u Smoking Increase the number of smokers
counseled to quit and referred to quitlines by
health care workers increase availability of no
or low-cost cessation products and collaborate
with efforts to increase the percentage of the
population protected by smoke-free air laws
and regulations
To a lesser extent state HDSP programs work to
improve emergency response and quality of acute
care systems
State HDSP programs work to eliminate health
disparities in priority populations (ie groups with
increased burden or need based on race ethnicity
gender geography or socioeconomic status) as an
overarching principle
bull Collaborate with chronic disease programs (eg
those focusing on tobacco diabetes physical
inactivity poor nutrition and obesityoverweight)
and partners to develop and integrate population-
based strategies to prevent heart disease and
stroke
bull Promote cardiovascular health in health care
worksite and community settings through policy
and systems changes
bull Identify and evaluate promising practices to
address heart disease and stroke
bull Conduct surveillance of heart disease stroke
and related risk factors
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
15
u
u
Key Responsibilities of State Capacity Building Programs bull Facilitate collaboration with public- and private-
sector partners such as not-for-profit health
agencies health systems organizations emergency
response agencies federally funded health centers
businesses priority population organizations and
voluntary health organizations
bull Document the state burden of heart disease
stroke and related risk factors
bull Develop plans for population-based strategies
for preventing heart disease and stroke among
general and Priority Populations
bull Develop a comprehensive state HDSP plan
bull Develop an HDSP program logic model and
evaluation plan
bull Assess assets and gaps in state policy and systems
related to HDSP in health care worksite and
community settings
Key Responsibilities of State Basic Implementation Programs bull Enhance all capacity-building program activities
bull Implement and evaluate policy systems change
and educational interventions that address the
six HDSP program priority areas in health care
worksite and community settings
bull Provide training and technical assistance to
public health and health care professionals and
partners to support policy and system changes
that will encourage heart disease and stroke
prevention
How CDC Assists State Heart Disease and Stroke Prevention Programs bull Provides training technical assistance and
funding
bull Funds applied research on heart disease and
stroke interventions and elimination of disparities
that is relevant to state programs
bull Identifies and disseminates science-based
promising practices
bull Partners with national organizations to help states
address prevention of heart disease and stroke
bull Facilitates collaborations with other state chronic
disease programs or activities that address risk
factors populations or settings related to heart
disease and stroke prevention and program
priority areas
bull Develops and disseminates publications and tools
such as
u CDCynergy a CD-ROM-based tool for
planning health communication interventions
State Heart Disease and Stroke Prevention
Program Evaluation Framework (wwwcdc
govdhdsplibraryevaluation_framework
indexhtm) a document providing guidance
on systematic ways to measure the success of
public health programs and on logic model
development
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping an
Evaluation Plan (wwwcdcgovDHDSPstate_
programevaluation_guidesevaluation_plan
htm) a document providing guidance on the
development of evaluation activities to help
programs identify required staff time and
resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
16
u
u
u
u
u
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping and
Using a Logic Model (wwwcdcgovDHDSP
state_programevaluation_guideslogic_model
htm) a document providing guidance on
the development and use of logic models as
planning and evaluation tools
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashWriting SMART
Objectives (wwwcdcgovDHDSPstate_
programevaluation_guidessmart_objectives
htm) a document providing guidance to
states on the development of realistic and
measurable objectives
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit (wwwcdcgov
dhdsplibrarytoolkitindexhtm) a document
that provides information materials and
tools that state programs can reference and
distribute to businesses primarily through
employer and professional organizations
Heart Disease and Stroke Interactive Maps
(wwwcdcgovdhdsplibrarymapsstatemaps
htm) which present heart disease and stroke
mortality rates by county for the state racial
ethnic group and gender of the userrsquos choice
A Communication Guide for Policy and
Environmental Change (wwwcdcgovdhdsp
libraryheart_stroke_guideindexhtm) which
includes information references and examples
of communication from state programs and
Stroke Addendum to the Communication
Guide (wwwcdcgovdhdsplibraryheart_
stroke_guideindexhtm)
For additional information please visit the CDC
website at wwwcdcgovdhdsp or contact the
Division for Heart Disease and Stroke Prevention
Program Development and Services Branch at
(770) 488-2424
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17
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
State Heart Disease and Stroke Prevention Program Funding Opportunity Announcement DP07-704 At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
18
Introduction The Funding Opportunity Announcement
(FOA) DP07-704 At-A-Glance provides important
information to assist programs funded under this
announcement to deliver their program as intended
The At-A-Glance highlights aspects of FOA DP07-704
important for all funded programs including
the following
bull Overview of the National Heart Disease and
Stroke Prevention Program
bull Heart Disease and Stroke Prevention State
Program roles
bull Performance measures for Capacity Building Basic
Implementation Optional Funding for Capacity
Building programs and Stroke Networks
bull Funded program reporting requirements
bull Budgetfunding guidance
bull National and administrative policy requirements
If a program needs a copy of the full document
it should contact its project officer (see Program
Contacts section of the full National Heart Disease
and Stroke Prevention Program Staff Orientation
Manual) to fulfill that request
Section 1 Background In 1998 the US Congress provided funding for
CDC to initiate a national state-based cardiovascular
health program The Senate Appropriations
Committee in 2005 encouraged CDC to create the
Division for Heart Disease and Stroke Prevention and
increased resources enabling CDC to reach 32 of the
50 states and the District of Columbia with funding
for heart disease and stroke prevention As of 2008
the Heart Disease and Stroke Prevention (HDSP)
program funds 41 states and the District of Columbia
As the Division for Heart Disease and Stroke
Prevention developed so did the focus of the State
HDSP Program Focusing on the six program priority
areas (noted below) should impact morbidity and
mortality of these diseases State programs should
increase heart disease and stroke prevention policies
and systems change with the potential to impact
the general population and Priority Populations
(see Prevention Works CDC Strategies for a Heart-
healthy and Stroke-free America wwwCDCgov
dhdsplibrary) For more information on the CDC
State HDSP Program visit wwwcdcgovdhdspState_
programindexhtm
A Public Health Action Plan to Prevent Heart Disease
and Stroke (see wwwCDCgovdhdsplibrary)
documents the multiple intervention opportunities
for preventing heart disease and stroke It is
important to work with partners collaboratively in
leveraging resources to address the multiple risk
factors that are associated with these diseases
Announcement DP07-704 supports program
components considered essential to enhancing
the leadership of state health departments in
heart disease and stroke prevention It provides
for the funding of capacity building and basic
implementation programs as well as projects such as
the Optional Funding for Capacity Building Programs
and Stroke Networks
A capacity building program develops the foundation
for a comprehensive cardiovascular disease prevention
program through such activities as partnership
development definition of the burden and
development of a state plan A basic implementation
program enhances capacity building activities and
implements disseminates and evaluates intervention
activities that address the state plan objectives and the
CDC program priority areas 1ndash6
1 Increase control of high blood pressure primarily
in adults and older adults
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19
2 Increase control of high blood cholesterol
primarily in adults and older adults
3 Increase knowledge of signs and symptoms for
heart attack and stroke and the importance of
calling 9-1-1
4 Improve emergency response
5 Improve quality of heart disease and stroke care
6 Eliminate disparities in terms of race ethnicity
gender geography or socioeconomic status
Optional Funding for Capacity Building Programs
provides support to programs to implement an
evidence-based or promising practice demonstration
project that addresses the CDC program priority
areas 1ndash6
Stroke Networks support a state health department to
increase stroke prevention activities across a group of
three to six contiguous member states with emphasis
on increasing awareness and implementing priority
policy or systems changes across the states
The State HDSP Program is anchored on the
framework of the Socio-ecological Model which
conceptualized the influences of individual
behaviors family and social relationships community
and environmental effects and societal influences
such as policies on health status In order to
promote significant impact for improving the health
of the population interventions should focus on
implementing policy and systems change strategies
that support heart disease and stroke prevention
Policy change can be addressed through a) public
policy (eg establishing certification for hospital-
based stroke centers) or b) organizational policy
(eg businesses providing health benefits plans
that cover preventive services that include blood
pressure control)
System changes are encouraged in three settings
worksites health care and communities An
example of a systems change is when a health
care setting implements electronic records and
patient care management systems that improve the
quality of health care Interventions within systems
are encouraged at the highest level possiblemdashfor
example activities with business coalitions rather
than individual worksites and with managed care
organizations (MCOs) and state medical associations
rather than individual health care sites or physicians
By working at higher levels to affect systems change
states can impact larger segments of the population
Education and awareness efforts to enhance
public understanding and promote actions related
to cardiovascular diseases and the risk factors of
high blood pressure and high cholesterol signs
and symptoms of heart attack and stroke and the
need to call 9-1-1 are also components of capacity
enhancement
An overarching goal of the State HDSP Program
is to address disparities in heart disease and
stroke and the related risk factors using policy and
systems change strategies Based on disparities
(eg raceethnicity gender geographic geography
socioeconomic status) in mortality access to care
or burden of risk factors the State HDSP Program
should identify Priority Populations and implement
interventions to reach those Priority Populations
No one organization will be able to address the
prevention of heart disease and stroke It will require
many organizations working in collaboration if
progress is to be made in accomplishing the Healthy
People 2010 Objectives Collaboration is defined
by the Wilder Foundation as ldquoa mutually beneficial
and well-defined relationship entered into by two
or more organizations to achieve common goals
The relationship includes a commitment to mutual
relationships and goals a jointly developed structure
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20
and shared responsibility mutual authority and
accountability for success and sharing of resources
and rewardsrdquo Developing and maintaining
strategic partnerships are key to the leveraging of
skills and resources to prevent heart disease and
stroke in a comprehensive way The State HDSP
Program has two major roles related to partners
The first is to convene or facilitate collaboration
to develop and implement a comprehensive state
plan and intervention implementation strategies
that addresses heart disease stroke and related
risk factors The second is to develop strategies to
leverage resources and coordinate interventions
with partners that address the six program
priority areas
A logic model has been developed to describe
the State HDSP Program as intended by the CDC
funding to state health departments (see following
page) The model depicts relationships and actions
(eg links between environment and policy
change and individual-level behavioral change)
that are expected to culminate in reduction in
heart disease and stroke
The CDC and state activities are outlined in terms
of capacity building surveillancemonitoring
and interventions Both CDC and state activities
influence changes that lead to short-term
outcomes such as development of a work plan
and strategies for system-level changes effective
implementation of interventions and action by
target audiences and change agents (those who are
in the position to influence policies and systems
such as hospital administrators and MCO decision
makers) These activities and outcomes result in
changes in policy and environmental supports
which in turn influence behavior changes and
improve health status Ultimately these changes
decrease premature death and disability and
eliminate cardiovascular disparities between
general and Priority Populations
The State HDSP logic model also is a tool to guide
program evaluation By identifying the steps
necessary to reach intended outcomes the logic
model provides guidance in evaluating the short and
intermediate outcomes of the program
State evaluation efforts should relate to the National
HDSP Program logic model or to a logic model that
the state develops that complements the national
model and the required program recipient activities
The logic model can also be seen in the CDC
Evaluation Framework for Heart Disease and Stroke
Prevention State Programs at wwwcdcgovdhdsp
Section 2 National Heart Disease and Stroke Prevention State Program Roles In A Public Health Action Plan to Prevent Heart
Disease and Stroke there are four major goals which
are based on Healthy People 2010
Goal 1 Prevention of risk factors
Goal 2 Detection and treatment of risk factors
Goal 3 Early identification and treatment of heart
attacks and strokes
Goal 4 Prevention of recurrent cardiovascular events
CDC-funded State HDSP Programs have a direct
impact on Goals 2 3 and 4 by addressing HDSP
program priority areas 1ndash6 (see Background section)
HDSP programs have a supportive role with other
state health department programs and partners in
addressing Goal 1 Efforts to address Goal 1 related
to tobacco use diabetes obesity poor nutrition
physical inactivity and schools as a worksite should
be done through a supportive or collaborative role
with the state WISEWOMAN diabetes tobacco
nutrition physical activity or coordinated school
health programs
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bull State HDSP Programs are encouraged to
coordinate with other programs in ways that
1 Address Goal 1 (eg State HDSP and Nutrition
Programs identify primary prevention messages
related to cholesterol and salt to be included in Nushy
trition Programs where appropriate State HDSP and
Tobacco Programs collaborate to promote use of
state tobacco quit lines State HDSP Program refers
managed care organizations to materials developed
by the Parks and Recreation Department and
Physical Activity Program on safe places to exercise
National HDSP Program Logic Model
State HDSP and WISEWOMAN Programs collaborate
to create systems for educating health care providers
on guidelines focused on risk factor prevention)
2 Enhance inclusion of key messages in the work
of related programs (eg State HDSP Program
works to implement JNC7 guidelines which
include referral to nutrition counseling the
WISEWOMAN Program incorporates education on
signs and symptoms of heart disease and stroke
into ongoing activities the State HDSP Program
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and system change supports
Level bull State bull Local
Settings bull Community bull Health care bull Worksite
Context bull Priority
Populations bull General
populations
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective intervention
implemented focused on
settings and Priority Populations
Change agents
take action
Activate intended audiences
Capa
city B
uildin
gSu
rveil
lance
Inter
vent
ions
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
21
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encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
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23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
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25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
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26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
9
Management Information System (MIS) In 2008
DHDSP completed revisions for the heart disease
and stroke prevention Web-based MIS The report
generated by the system was changed to a table that
displays an objective time frame status and progress
in an easy-to-read format These changes made the
system more user friendly for states and CDC The
MIS can now be used to
bull Describe state program activities and expected
use of CDC funds
bull Track progress on state program activities and
identify promising practices
bull Assist CDC in identifying the need for training
and technical assistance
bull Standardize the state reporting process to
facilitate evaluation
bull Enable CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Funded Partnerships
Directors of Health Promotion and Education
(DHPE) In 2008 DHDSP continued to support
the DHPECDC Internship Program for Students
of Minority Serving Institutions
National Stroke Association DHDSP assisted with
funding for the Sixth Annual National Public Health
Stroke Summit conducted by the National Stroke
Association in Denver Colorado in December 2007
The Summit brought together 105 state public health
and health care professionals to promote information
sharing knowledge and skill building networking
and partnership development
National Collaborations
Cardiovascular Health (CVH) Council of the National Association of Chronic Disease Directors (NACDD) In 2008 the CVH Council
updated its section of the NACDD website to include
additional materials useful to states and it started
a Web discussion forum that allows states to share
ideas and products The Council obtained private
funds and sponsored the 2-day Northeast Regional
Workshop on Cholesterol Control in which 11
states participated in May 2008 It also funded two
of the participating states (Maine and Maryland)
to do follow-up work on cholesterol control with
their primary care associations and local federally
qualified health centers In March 2008 the
Council led the development of a themed issue of
the e-journal Preventing Chronic Disease In most
cases state program staff coauthored articles with
DHDSP staff The CVH Council worked with DHDSP
to assess the training needs of state programs in
the National Heart Disease and Stroke Prevention
Program and DHDSP used this information to plan
its September 2008 3-day training workshop for state
program and WISEWOMAN staff
Epidemiology and Surveillance Branch
Cardiac Arrest Registry to Enhance Survival
The Cardiac Arrest Registry to Enhance Survival
(CARES) began in 2005 in Atlanta and has since
expanded to 40 communities in 23 states CARES is
a simple but robust registry of cardiac arrest events
that allows participating sites to enter data related
to out-of-hospital cardiac arrest (OHCA) generate
summary reports and compare local data with
similar EMS systems elsewhere Three sources of
data are linked to describe each OHCA event 1)
9-1-1 call center data (to provide incident address
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
10
and dispatch and arrival times) 2) EMS data (to
describe initially recorded cardiac rhythm and
treatment methods) and 3) hospital data (emergency
department and hospital outcome hypothermia
treatment and neurologic status at discharge)
Multiple reporting features can be generated and
monitored continuously through secure online access
by CARES participants which allows for longitudinal
internal benchmarking Local EMS administrators
and medical directors are able to identify when and
where cardiac arrests occur which elements of their
EMS system are functioning properly in dealing
with these cases and what changes can be made to
improve outcomes In 2011 CARES began expanding
to statewide participation in six states which will
allow additional communities of different sizes and
population densities to be included in the registry In
addition state-level participation will promote better
communication and collaboration between state and
local EMS providers A recent MMWR Surveillance
Summary was published summarizing CARES data
collected during October 1 2005ndashDecember 31
2010 (wwwcdcgovmmwrpdfssss6008pdf) More
information about CARES can be found on the
CARES website at httpsmycaresnet
Paul Coverdell National Acute Stroke Registry
New Registries The Paul Coverdell National
Acute Stroke Registry program successfully
implemented stroke registries in three newly
funded states in 2007 (Michigan Minnesota and
Ohio) These states made much greater progress
in their first year toward developing program
infrastructure collecting data and engaging in
quality improvement activities than had the four
states that completed their first year of Coverdell
Registry funding in 2004 Much of this progress can
be attributed to CDCrsquos increased capacity to provide
proactive technical assistance to states through
conference calls work groups and resource
materials such as the program resource manual
Supplemental Projects The Coverdell Registry
team developed and funded a supplemental
cooperative agreement to pilot the expansion of
the Coverdell Registry model to other domains
within stroke systems of care North Carolina was
funded to demonstrate the feasibility of linking
pre-hospital EMS data for stroke with the state
Coverdell Registry (the North Carolina Stroke
Care Collaborative) In 2010 in partnership with
the Association of State and Territorial Health
Officials CDC funded two Coverdell states to
develop comprehensive statewide stroke care
systems plans CDC is currently funding the Ohio
Coverdell Registry to study 30-day outcomes
of stroke patients based on the quality of care
provided In partnership with the Agency for
Healthcare Research and Quality CDC has funded
an evidence-based review of transitions in care
from hospital to home or rehabilitation for stroke
patients
National Evaluation Plan Through a yearlong
collaboration with RTI International the Coverdell
Registry developed a national evaluation plan The
plan provides a systematic method of assessing
the annual and long-term performance of the
program including strategic goals and objectives
performance goals performance measures and
targets for program outcomes
Consensus Stroke Performance Measures
Endorsement of the Consensus Stroke
Performance Measures The Coverdell Registry
partnered with the American Heart Association
and The Joint Commission to develop performance
measures for acute stroke care commonly
referred to as the Consensus Stroke Performance
Measures These measures were released to
hospitals throughout the United States in fall
2007 In January 2008 more than 1200 hospitals
began using these measures to improve the quality
of care for acute stroke patients The measures
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
11
were submitted to the National Quality Forum in
March 2008 and 8 of the 10 were adopted This
endorsement of the Consensus Stroke Performance
Measures has paved the way for adoption of
these measures by the Centers for Medicare
and Medicaid Services for quality reporting and
meaningful use
Quarterly Data Reports With the implementation
of the Consensus Stroke Performance Measures in
January 2008 CDC began providing states with
quarterly data reports on the measures These
reports provide each state with a summary of its
data on ischemic stroke hemorrhagic stroke and
transient ischemic attacks as well as aggregate data
for all states in the Coverdell Registry program
Applied Research and Evaluation Branch
Building an Economic Evaluation Research Agenda
Based on program needs and research gaps in heart
disease and stroke prevention the Applied Research
and Evaluation Branch developed an agenda to
guide economic research on 1) economic burden
of cardiovascular diseases and cost-effectiveness of
their control 2) economic value of DHDSP-funded
and other state prevention programs 3) CDCrsquos
Internet-based clearinghouse for information on
the economics of cardiovascular diseases and 4)
developing partnerships in economic research to
increase the impact of such research
Stroke Awareness Signs and Symptoms Awareness Campaigns
To provide guidance for state programs a review of
current research on stroke awareness campaigns was
undertaken to identify evidence to support the most
appropriate ways to increase knowledge of signs and
symptoms for stroke the importance of calling 9-1-1
and relationships between the educational campaigns
and outcomes related to awareness of stroke signs
and symptoms
The literature review and synthesis of current
research on stroke awareness campaigns resulted
in the following dissemination activities
bull Development of a fact sheet for state programs on
literature review findings and considerations for
statesrsquo current activities related to stroke awareness
messages including direct education and tools
available to facilitate campaign development
bull Poster presentation at the 2008 National
Conference on Health Communication Marketing
and Media on evaluation guidance for stroke
awareness campaigns The presentation outlined
specific information for states and communities on
how to strengthen the effectiveness and outcome
evaluation of their stroke awareness campaigns
bull Presentation at the 2008 National Heart Disease
and Stroke Prevention Training Institute about
evidence and research on communication and
media campaigns impact considerations of cost
opportunities for partnering and evaluating
results
Comprehensive and Core Indicators
DHDSP released a set of core indicators for
hypertension as part of a comprehensive evidence-
based set of indicators to guide state heart disease
and stroke prevention programs in evaluating their
efforts State health departments received related
key guidance documents training at the National
Heart Disease and Stroke Prevention Training
Institute and a series of follow-up trainings
Indicators are presented in a Consumer Reports
format and rated on multiple dimensions such as
strength of scientific evidence feasibility of data
collection and face validity
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
12
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkitmdash Evaluation Results
CDC worked with the American Institutes for
Research (AIR) to conduct an evaluation of the
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit State health departments
(SHDs) were trained to use the toolkit to promote
state employer-based initiatives on workplace efforts
for heart disease and stroke prevention
From 2005 to 2007 all the SHDs received copies of
the toolkit and were invited to attend training sessions
(one seminar five webinars and three consultations)
To evaluate the usefulness of the toolkit materials
and obtain recommendations two focus groups with
business leaders and Web-based surveys of the SHDs
were conducted In 2006 all 50 states and the District
of Columbia completed the baseline and in 2008 40
states completed the follow-up
Of the 40 SHDs that completed both waves of the
survey the proportion that reported engaging in
employer-based initiatives significantly increased
from 65 percent to 725 percent during the period
examined despite a reported reduction in staff and
limited appropriations About 90 percent of the
SHDs that responded to the 2008 survey are now
working with employers to promote comprehensive
heart disease and stroke prevention programs
disseminate best practices establish employer-
oriented partnerships participate in seminars for
employers and provide business leaders with
resources Partnerships with employer groups or
business coalitions have focused on worksite policy
changes health promotion and education and
worksite surveillance and assessments In parallel
to these experiences the SHDs have increased their
overall level of confidence in their knowledge and
skills Most of the SHDs (61 percent) agreed that
the CDC trainings and consultations helped them
improve their heart disease and stroke prevention
programs and use the toolkit more effectively
Participation in the trainings was positively associated
with engagement in worksite health promotion and
education The SHDs that received federal funding
had significantly higher participation in macro-
marketing activities reaching employers through
business coalitions associations task forces and
champions and were more likely to establish
partnerships with employer groups and government
agencies
The Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit is available at wwwcdc
govdhdsplibrarytoolkitindexhtm
The Branch also provides economics support to
the Division and partners by documenting costs of
cardiovascular diseases and their risk factors and
identifying cost-effective interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
13
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
National Heart Disease and Stroke Prevention Program Overview
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
14
u Blood pressure Prevent and control high blood Program Overview pressure reduce sodium intake
bull In 1998 the US Congress provided funding
for CDC to initiate a national state-based Heart
Disease and Stroke Prevention (HDSP) program in
eight states
bull CDC funds programs in 41 states and the
District of Columbia Twenty-eight are capacity
building (planning) programs and 14 are basic
implementation (intervention) programs
bull Capacity Building Programs Alabama
Alaska Arizona California Colorado Connecticut
District of Columbia Hawaii Idaho Illinois Iowa
Kansas Kentucky Louisiana Maryland Michigan
Minnesota Mississippi Nebraska New Jersey
North Dakota Ohio Oklahoma Oregon Rhode
Island Tennessee Texas and Wisconsin
bull Basic Implementation Programs Arkansas
Florida Georgia Maine Massachusetts Missouri
Montana New York North Carolina South
Carolina Utah Virginia Washington and West
Virginia
National Heart Disease and Stroke Prevention Program Goals bull Enhance state capacity to plan implement track
and sustain population-based interventions to
address heart disease stroke and related risk
factors Focus program efforts on population-
based policy and systems change strategies to
impact the ldquoABCSrdquo of heart disease and stroke
prevention
u Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
u Cholesterol Prevent and control high
cholesterol
u Smoking Increase the number of smokers
counseled to quit and referred to quitlines by
health care workers increase availability of no
or low-cost cessation products and collaborate
with efforts to increase the percentage of the
population protected by smoke-free air laws
and regulations
To a lesser extent state HDSP programs work to
improve emergency response and quality of acute
care systems
State HDSP programs work to eliminate health
disparities in priority populations (ie groups with
increased burden or need based on race ethnicity
gender geography or socioeconomic status) as an
overarching principle
bull Collaborate with chronic disease programs (eg
those focusing on tobacco diabetes physical
inactivity poor nutrition and obesityoverweight)
and partners to develop and integrate population-
based strategies to prevent heart disease and
stroke
bull Promote cardiovascular health in health care
worksite and community settings through policy
and systems changes
bull Identify and evaluate promising practices to
address heart disease and stroke
bull Conduct surveillance of heart disease stroke
and related risk factors
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
15
u
u
Key Responsibilities of State Capacity Building Programs bull Facilitate collaboration with public- and private-
sector partners such as not-for-profit health
agencies health systems organizations emergency
response agencies federally funded health centers
businesses priority population organizations and
voluntary health organizations
bull Document the state burden of heart disease
stroke and related risk factors
bull Develop plans for population-based strategies
for preventing heart disease and stroke among
general and Priority Populations
bull Develop a comprehensive state HDSP plan
bull Develop an HDSP program logic model and
evaluation plan
bull Assess assets and gaps in state policy and systems
related to HDSP in health care worksite and
community settings
Key Responsibilities of State Basic Implementation Programs bull Enhance all capacity-building program activities
bull Implement and evaluate policy systems change
and educational interventions that address the
six HDSP program priority areas in health care
worksite and community settings
bull Provide training and technical assistance to
public health and health care professionals and
partners to support policy and system changes
that will encourage heart disease and stroke
prevention
How CDC Assists State Heart Disease and Stroke Prevention Programs bull Provides training technical assistance and
funding
bull Funds applied research on heart disease and
stroke interventions and elimination of disparities
that is relevant to state programs
bull Identifies and disseminates science-based
promising practices
bull Partners with national organizations to help states
address prevention of heart disease and stroke
bull Facilitates collaborations with other state chronic
disease programs or activities that address risk
factors populations or settings related to heart
disease and stroke prevention and program
priority areas
bull Develops and disseminates publications and tools
such as
u CDCynergy a CD-ROM-based tool for
planning health communication interventions
State Heart Disease and Stroke Prevention
Program Evaluation Framework (wwwcdc
govdhdsplibraryevaluation_framework
indexhtm) a document providing guidance
on systematic ways to measure the success of
public health programs and on logic model
development
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping an
Evaluation Plan (wwwcdcgovDHDSPstate_
programevaluation_guidesevaluation_plan
htm) a document providing guidance on the
development of evaluation activities to help
programs identify required staff time and
resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
16
u
u
u
u
u
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping and
Using a Logic Model (wwwcdcgovDHDSP
state_programevaluation_guideslogic_model
htm) a document providing guidance on
the development and use of logic models as
planning and evaluation tools
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashWriting SMART
Objectives (wwwcdcgovDHDSPstate_
programevaluation_guidessmart_objectives
htm) a document providing guidance to
states on the development of realistic and
measurable objectives
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit (wwwcdcgov
dhdsplibrarytoolkitindexhtm) a document
that provides information materials and
tools that state programs can reference and
distribute to businesses primarily through
employer and professional organizations
Heart Disease and Stroke Interactive Maps
(wwwcdcgovdhdsplibrarymapsstatemaps
htm) which present heart disease and stroke
mortality rates by county for the state racial
ethnic group and gender of the userrsquos choice
A Communication Guide for Policy and
Environmental Change (wwwcdcgovdhdsp
libraryheart_stroke_guideindexhtm) which
includes information references and examples
of communication from state programs and
Stroke Addendum to the Communication
Guide (wwwcdcgovdhdsplibraryheart_
stroke_guideindexhtm)
For additional information please visit the CDC
website at wwwcdcgovdhdsp or contact the
Division for Heart Disease and Stroke Prevention
Program Development and Services Branch at
(770) 488-2424
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
17
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
State Heart Disease and Stroke Prevention Program Funding Opportunity Announcement DP07-704 At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
18
Introduction The Funding Opportunity Announcement
(FOA) DP07-704 At-A-Glance provides important
information to assist programs funded under this
announcement to deliver their program as intended
The At-A-Glance highlights aspects of FOA DP07-704
important for all funded programs including
the following
bull Overview of the National Heart Disease and
Stroke Prevention Program
bull Heart Disease and Stroke Prevention State
Program roles
bull Performance measures for Capacity Building Basic
Implementation Optional Funding for Capacity
Building programs and Stroke Networks
bull Funded program reporting requirements
bull Budgetfunding guidance
bull National and administrative policy requirements
If a program needs a copy of the full document
it should contact its project officer (see Program
Contacts section of the full National Heart Disease
and Stroke Prevention Program Staff Orientation
Manual) to fulfill that request
Section 1 Background In 1998 the US Congress provided funding for
CDC to initiate a national state-based cardiovascular
health program The Senate Appropriations
Committee in 2005 encouraged CDC to create the
Division for Heart Disease and Stroke Prevention and
increased resources enabling CDC to reach 32 of the
50 states and the District of Columbia with funding
for heart disease and stroke prevention As of 2008
the Heart Disease and Stroke Prevention (HDSP)
program funds 41 states and the District of Columbia
As the Division for Heart Disease and Stroke
Prevention developed so did the focus of the State
HDSP Program Focusing on the six program priority
areas (noted below) should impact morbidity and
mortality of these diseases State programs should
increase heart disease and stroke prevention policies
and systems change with the potential to impact
the general population and Priority Populations
(see Prevention Works CDC Strategies for a Heart-
healthy and Stroke-free America wwwCDCgov
dhdsplibrary) For more information on the CDC
State HDSP Program visit wwwcdcgovdhdspState_
programindexhtm
A Public Health Action Plan to Prevent Heart Disease
and Stroke (see wwwCDCgovdhdsplibrary)
documents the multiple intervention opportunities
for preventing heart disease and stroke It is
important to work with partners collaboratively in
leveraging resources to address the multiple risk
factors that are associated with these diseases
Announcement DP07-704 supports program
components considered essential to enhancing
the leadership of state health departments in
heart disease and stroke prevention It provides
for the funding of capacity building and basic
implementation programs as well as projects such as
the Optional Funding for Capacity Building Programs
and Stroke Networks
A capacity building program develops the foundation
for a comprehensive cardiovascular disease prevention
program through such activities as partnership
development definition of the burden and
development of a state plan A basic implementation
program enhances capacity building activities and
implements disseminates and evaluates intervention
activities that address the state plan objectives and the
CDC program priority areas 1ndash6
1 Increase control of high blood pressure primarily
in adults and older adults
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19
2 Increase control of high blood cholesterol
primarily in adults and older adults
3 Increase knowledge of signs and symptoms for
heart attack and stroke and the importance of
calling 9-1-1
4 Improve emergency response
5 Improve quality of heart disease and stroke care
6 Eliminate disparities in terms of race ethnicity
gender geography or socioeconomic status
Optional Funding for Capacity Building Programs
provides support to programs to implement an
evidence-based or promising practice demonstration
project that addresses the CDC program priority
areas 1ndash6
Stroke Networks support a state health department to
increase stroke prevention activities across a group of
three to six contiguous member states with emphasis
on increasing awareness and implementing priority
policy or systems changes across the states
The State HDSP Program is anchored on the
framework of the Socio-ecological Model which
conceptualized the influences of individual
behaviors family and social relationships community
and environmental effects and societal influences
such as policies on health status In order to
promote significant impact for improving the health
of the population interventions should focus on
implementing policy and systems change strategies
that support heart disease and stroke prevention
Policy change can be addressed through a) public
policy (eg establishing certification for hospital-
based stroke centers) or b) organizational policy
(eg businesses providing health benefits plans
that cover preventive services that include blood
pressure control)
System changes are encouraged in three settings
worksites health care and communities An
example of a systems change is when a health
care setting implements electronic records and
patient care management systems that improve the
quality of health care Interventions within systems
are encouraged at the highest level possiblemdashfor
example activities with business coalitions rather
than individual worksites and with managed care
organizations (MCOs) and state medical associations
rather than individual health care sites or physicians
By working at higher levels to affect systems change
states can impact larger segments of the population
Education and awareness efforts to enhance
public understanding and promote actions related
to cardiovascular diseases and the risk factors of
high blood pressure and high cholesterol signs
and symptoms of heart attack and stroke and the
need to call 9-1-1 are also components of capacity
enhancement
An overarching goal of the State HDSP Program
is to address disparities in heart disease and
stroke and the related risk factors using policy and
systems change strategies Based on disparities
(eg raceethnicity gender geographic geography
socioeconomic status) in mortality access to care
or burden of risk factors the State HDSP Program
should identify Priority Populations and implement
interventions to reach those Priority Populations
No one organization will be able to address the
prevention of heart disease and stroke It will require
many organizations working in collaboration if
progress is to be made in accomplishing the Healthy
People 2010 Objectives Collaboration is defined
by the Wilder Foundation as ldquoa mutually beneficial
and well-defined relationship entered into by two
or more organizations to achieve common goals
The relationship includes a commitment to mutual
relationships and goals a jointly developed structure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
20
and shared responsibility mutual authority and
accountability for success and sharing of resources
and rewardsrdquo Developing and maintaining
strategic partnerships are key to the leveraging of
skills and resources to prevent heart disease and
stroke in a comprehensive way The State HDSP
Program has two major roles related to partners
The first is to convene or facilitate collaboration
to develop and implement a comprehensive state
plan and intervention implementation strategies
that addresses heart disease stroke and related
risk factors The second is to develop strategies to
leverage resources and coordinate interventions
with partners that address the six program
priority areas
A logic model has been developed to describe
the State HDSP Program as intended by the CDC
funding to state health departments (see following
page) The model depicts relationships and actions
(eg links between environment and policy
change and individual-level behavioral change)
that are expected to culminate in reduction in
heart disease and stroke
The CDC and state activities are outlined in terms
of capacity building surveillancemonitoring
and interventions Both CDC and state activities
influence changes that lead to short-term
outcomes such as development of a work plan
and strategies for system-level changes effective
implementation of interventions and action by
target audiences and change agents (those who are
in the position to influence policies and systems
such as hospital administrators and MCO decision
makers) These activities and outcomes result in
changes in policy and environmental supports
which in turn influence behavior changes and
improve health status Ultimately these changes
decrease premature death and disability and
eliminate cardiovascular disparities between
general and Priority Populations
The State HDSP logic model also is a tool to guide
program evaluation By identifying the steps
necessary to reach intended outcomes the logic
model provides guidance in evaluating the short and
intermediate outcomes of the program
State evaluation efforts should relate to the National
HDSP Program logic model or to a logic model that
the state develops that complements the national
model and the required program recipient activities
The logic model can also be seen in the CDC
Evaluation Framework for Heart Disease and Stroke
Prevention State Programs at wwwcdcgovdhdsp
Section 2 National Heart Disease and Stroke Prevention State Program Roles In A Public Health Action Plan to Prevent Heart
Disease and Stroke there are four major goals which
are based on Healthy People 2010
Goal 1 Prevention of risk factors
Goal 2 Detection and treatment of risk factors
Goal 3 Early identification and treatment of heart
attacks and strokes
Goal 4 Prevention of recurrent cardiovascular events
CDC-funded State HDSP Programs have a direct
impact on Goals 2 3 and 4 by addressing HDSP
program priority areas 1ndash6 (see Background section)
HDSP programs have a supportive role with other
state health department programs and partners in
addressing Goal 1 Efforts to address Goal 1 related
to tobacco use diabetes obesity poor nutrition
physical inactivity and schools as a worksite should
be done through a supportive or collaborative role
with the state WISEWOMAN diabetes tobacco
nutrition physical activity or coordinated school
health programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
bull State HDSP Programs are encouraged to
coordinate with other programs in ways that
1 Address Goal 1 (eg State HDSP and Nutrition
Programs identify primary prevention messages
related to cholesterol and salt to be included in Nushy
trition Programs where appropriate State HDSP and
Tobacco Programs collaborate to promote use of
state tobacco quit lines State HDSP Program refers
managed care organizations to materials developed
by the Parks and Recreation Department and
Physical Activity Program on safe places to exercise
National HDSP Program Logic Model
State HDSP and WISEWOMAN Programs collaborate
to create systems for educating health care providers
on guidelines focused on risk factor prevention)
2 Enhance inclusion of key messages in the work
of related programs (eg State HDSP Program
works to implement JNC7 guidelines which
include referral to nutrition counseling the
WISEWOMAN Program incorporates education on
signs and symptoms of heart disease and stroke
into ongoing activities the State HDSP Program
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and system change supports
Level bull State bull Local
Settings bull Community bull Health care bull Worksite
Context bull Priority
Populations bull General
populations
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective intervention
implemented focused on
settings and Priority Populations
Change agents
take action
Activate intended audiences
Capa
city B
uildin
gSu
rveil
lance
Inter
vent
ions
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
21
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
10
and dispatch and arrival times) 2) EMS data (to
describe initially recorded cardiac rhythm and
treatment methods) and 3) hospital data (emergency
department and hospital outcome hypothermia
treatment and neurologic status at discharge)
Multiple reporting features can be generated and
monitored continuously through secure online access
by CARES participants which allows for longitudinal
internal benchmarking Local EMS administrators
and medical directors are able to identify when and
where cardiac arrests occur which elements of their
EMS system are functioning properly in dealing
with these cases and what changes can be made to
improve outcomes In 2011 CARES began expanding
to statewide participation in six states which will
allow additional communities of different sizes and
population densities to be included in the registry In
addition state-level participation will promote better
communication and collaboration between state and
local EMS providers A recent MMWR Surveillance
Summary was published summarizing CARES data
collected during October 1 2005ndashDecember 31
2010 (wwwcdcgovmmwrpdfssss6008pdf) More
information about CARES can be found on the
CARES website at httpsmycaresnet
Paul Coverdell National Acute Stroke Registry
New Registries The Paul Coverdell National
Acute Stroke Registry program successfully
implemented stroke registries in three newly
funded states in 2007 (Michigan Minnesota and
Ohio) These states made much greater progress
in their first year toward developing program
infrastructure collecting data and engaging in
quality improvement activities than had the four
states that completed their first year of Coverdell
Registry funding in 2004 Much of this progress can
be attributed to CDCrsquos increased capacity to provide
proactive technical assistance to states through
conference calls work groups and resource
materials such as the program resource manual
Supplemental Projects The Coverdell Registry
team developed and funded a supplemental
cooperative agreement to pilot the expansion of
the Coverdell Registry model to other domains
within stroke systems of care North Carolina was
funded to demonstrate the feasibility of linking
pre-hospital EMS data for stroke with the state
Coverdell Registry (the North Carolina Stroke
Care Collaborative) In 2010 in partnership with
the Association of State and Territorial Health
Officials CDC funded two Coverdell states to
develop comprehensive statewide stroke care
systems plans CDC is currently funding the Ohio
Coverdell Registry to study 30-day outcomes
of stroke patients based on the quality of care
provided In partnership with the Agency for
Healthcare Research and Quality CDC has funded
an evidence-based review of transitions in care
from hospital to home or rehabilitation for stroke
patients
National Evaluation Plan Through a yearlong
collaboration with RTI International the Coverdell
Registry developed a national evaluation plan The
plan provides a systematic method of assessing
the annual and long-term performance of the
program including strategic goals and objectives
performance goals performance measures and
targets for program outcomes
Consensus Stroke Performance Measures
Endorsement of the Consensus Stroke
Performance Measures The Coverdell Registry
partnered with the American Heart Association
and The Joint Commission to develop performance
measures for acute stroke care commonly
referred to as the Consensus Stroke Performance
Measures These measures were released to
hospitals throughout the United States in fall
2007 In January 2008 more than 1200 hospitals
began using these measures to improve the quality
of care for acute stroke patients The measures
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
11
were submitted to the National Quality Forum in
March 2008 and 8 of the 10 were adopted This
endorsement of the Consensus Stroke Performance
Measures has paved the way for adoption of
these measures by the Centers for Medicare
and Medicaid Services for quality reporting and
meaningful use
Quarterly Data Reports With the implementation
of the Consensus Stroke Performance Measures in
January 2008 CDC began providing states with
quarterly data reports on the measures These
reports provide each state with a summary of its
data on ischemic stroke hemorrhagic stroke and
transient ischemic attacks as well as aggregate data
for all states in the Coverdell Registry program
Applied Research and Evaluation Branch
Building an Economic Evaluation Research Agenda
Based on program needs and research gaps in heart
disease and stroke prevention the Applied Research
and Evaluation Branch developed an agenda to
guide economic research on 1) economic burden
of cardiovascular diseases and cost-effectiveness of
their control 2) economic value of DHDSP-funded
and other state prevention programs 3) CDCrsquos
Internet-based clearinghouse for information on
the economics of cardiovascular diseases and 4)
developing partnerships in economic research to
increase the impact of such research
Stroke Awareness Signs and Symptoms Awareness Campaigns
To provide guidance for state programs a review of
current research on stroke awareness campaigns was
undertaken to identify evidence to support the most
appropriate ways to increase knowledge of signs and
symptoms for stroke the importance of calling 9-1-1
and relationships between the educational campaigns
and outcomes related to awareness of stroke signs
and symptoms
The literature review and synthesis of current
research on stroke awareness campaigns resulted
in the following dissemination activities
bull Development of a fact sheet for state programs on
literature review findings and considerations for
statesrsquo current activities related to stroke awareness
messages including direct education and tools
available to facilitate campaign development
bull Poster presentation at the 2008 National
Conference on Health Communication Marketing
and Media on evaluation guidance for stroke
awareness campaigns The presentation outlined
specific information for states and communities on
how to strengthen the effectiveness and outcome
evaluation of their stroke awareness campaigns
bull Presentation at the 2008 National Heart Disease
and Stroke Prevention Training Institute about
evidence and research on communication and
media campaigns impact considerations of cost
opportunities for partnering and evaluating
results
Comprehensive and Core Indicators
DHDSP released a set of core indicators for
hypertension as part of a comprehensive evidence-
based set of indicators to guide state heart disease
and stroke prevention programs in evaluating their
efforts State health departments received related
key guidance documents training at the National
Heart Disease and Stroke Prevention Training
Institute and a series of follow-up trainings
Indicators are presented in a Consumer Reports
format and rated on multiple dimensions such as
strength of scientific evidence feasibility of data
collection and face validity
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
12
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkitmdash Evaluation Results
CDC worked with the American Institutes for
Research (AIR) to conduct an evaluation of the
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit State health departments
(SHDs) were trained to use the toolkit to promote
state employer-based initiatives on workplace efforts
for heart disease and stroke prevention
From 2005 to 2007 all the SHDs received copies of
the toolkit and were invited to attend training sessions
(one seminar five webinars and three consultations)
To evaluate the usefulness of the toolkit materials
and obtain recommendations two focus groups with
business leaders and Web-based surveys of the SHDs
were conducted In 2006 all 50 states and the District
of Columbia completed the baseline and in 2008 40
states completed the follow-up
Of the 40 SHDs that completed both waves of the
survey the proportion that reported engaging in
employer-based initiatives significantly increased
from 65 percent to 725 percent during the period
examined despite a reported reduction in staff and
limited appropriations About 90 percent of the
SHDs that responded to the 2008 survey are now
working with employers to promote comprehensive
heart disease and stroke prevention programs
disseminate best practices establish employer-
oriented partnerships participate in seminars for
employers and provide business leaders with
resources Partnerships with employer groups or
business coalitions have focused on worksite policy
changes health promotion and education and
worksite surveillance and assessments In parallel
to these experiences the SHDs have increased their
overall level of confidence in their knowledge and
skills Most of the SHDs (61 percent) agreed that
the CDC trainings and consultations helped them
improve their heart disease and stroke prevention
programs and use the toolkit more effectively
Participation in the trainings was positively associated
with engagement in worksite health promotion and
education The SHDs that received federal funding
had significantly higher participation in macro-
marketing activities reaching employers through
business coalitions associations task forces and
champions and were more likely to establish
partnerships with employer groups and government
agencies
The Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit is available at wwwcdc
govdhdsplibrarytoolkitindexhtm
The Branch also provides economics support to
the Division and partners by documenting costs of
cardiovascular diseases and their risk factors and
identifying cost-effective interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
13
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
National Heart Disease and Stroke Prevention Program Overview
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
14
u Blood pressure Prevent and control high blood Program Overview pressure reduce sodium intake
bull In 1998 the US Congress provided funding
for CDC to initiate a national state-based Heart
Disease and Stroke Prevention (HDSP) program in
eight states
bull CDC funds programs in 41 states and the
District of Columbia Twenty-eight are capacity
building (planning) programs and 14 are basic
implementation (intervention) programs
bull Capacity Building Programs Alabama
Alaska Arizona California Colorado Connecticut
District of Columbia Hawaii Idaho Illinois Iowa
Kansas Kentucky Louisiana Maryland Michigan
Minnesota Mississippi Nebraska New Jersey
North Dakota Ohio Oklahoma Oregon Rhode
Island Tennessee Texas and Wisconsin
bull Basic Implementation Programs Arkansas
Florida Georgia Maine Massachusetts Missouri
Montana New York North Carolina South
Carolina Utah Virginia Washington and West
Virginia
National Heart Disease and Stroke Prevention Program Goals bull Enhance state capacity to plan implement track
and sustain population-based interventions to
address heart disease stroke and related risk
factors Focus program efforts on population-
based policy and systems change strategies to
impact the ldquoABCSrdquo of heart disease and stroke
prevention
u Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
u Cholesterol Prevent and control high
cholesterol
u Smoking Increase the number of smokers
counseled to quit and referred to quitlines by
health care workers increase availability of no
or low-cost cessation products and collaborate
with efforts to increase the percentage of the
population protected by smoke-free air laws
and regulations
To a lesser extent state HDSP programs work to
improve emergency response and quality of acute
care systems
State HDSP programs work to eliminate health
disparities in priority populations (ie groups with
increased burden or need based on race ethnicity
gender geography or socioeconomic status) as an
overarching principle
bull Collaborate with chronic disease programs (eg
those focusing on tobacco diabetes physical
inactivity poor nutrition and obesityoverweight)
and partners to develop and integrate population-
based strategies to prevent heart disease and
stroke
bull Promote cardiovascular health in health care
worksite and community settings through policy
and systems changes
bull Identify and evaluate promising practices to
address heart disease and stroke
bull Conduct surveillance of heart disease stroke
and related risk factors
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
15
u
u
Key Responsibilities of State Capacity Building Programs bull Facilitate collaboration with public- and private-
sector partners such as not-for-profit health
agencies health systems organizations emergency
response agencies federally funded health centers
businesses priority population organizations and
voluntary health organizations
bull Document the state burden of heart disease
stroke and related risk factors
bull Develop plans for population-based strategies
for preventing heart disease and stroke among
general and Priority Populations
bull Develop a comprehensive state HDSP plan
bull Develop an HDSP program logic model and
evaluation plan
bull Assess assets and gaps in state policy and systems
related to HDSP in health care worksite and
community settings
Key Responsibilities of State Basic Implementation Programs bull Enhance all capacity-building program activities
bull Implement and evaluate policy systems change
and educational interventions that address the
six HDSP program priority areas in health care
worksite and community settings
bull Provide training and technical assistance to
public health and health care professionals and
partners to support policy and system changes
that will encourage heart disease and stroke
prevention
How CDC Assists State Heart Disease and Stroke Prevention Programs bull Provides training technical assistance and
funding
bull Funds applied research on heart disease and
stroke interventions and elimination of disparities
that is relevant to state programs
bull Identifies and disseminates science-based
promising practices
bull Partners with national organizations to help states
address prevention of heart disease and stroke
bull Facilitates collaborations with other state chronic
disease programs or activities that address risk
factors populations or settings related to heart
disease and stroke prevention and program
priority areas
bull Develops and disseminates publications and tools
such as
u CDCynergy a CD-ROM-based tool for
planning health communication interventions
State Heart Disease and Stroke Prevention
Program Evaluation Framework (wwwcdc
govdhdsplibraryevaluation_framework
indexhtm) a document providing guidance
on systematic ways to measure the success of
public health programs and on logic model
development
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping an
Evaluation Plan (wwwcdcgovDHDSPstate_
programevaluation_guidesevaluation_plan
htm) a document providing guidance on the
development of evaluation activities to help
programs identify required staff time and
resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
16
u
u
u
u
u
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping and
Using a Logic Model (wwwcdcgovDHDSP
state_programevaluation_guideslogic_model
htm) a document providing guidance on
the development and use of logic models as
planning and evaluation tools
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashWriting SMART
Objectives (wwwcdcgovDHDSPstate_
programevaluation_guidessmart_objectives
htm) a document providing guidance to
states on the development of realistic and
measurable objectives
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit (wwwcdcgov
dhdsplibrarytoolkitindexhtm) a document
that provides information materials and
tools that state programs can reference and
distribute to businesses primarily through
employer and professional organizations
Heart Disease and Stroke Interactive Maps
(wwwcdcgovdhdsplibrarymapsstatemaps
htm) which present heart disease and stroke
mortality rates by county for the state racial
ethnic group and gender of the userrsquos choice
A Communication Guide for Policy and
Environmental Change (wwwcdcgovdhdsp
libraryheart_stroke_guideindexhtm) which
includes information references and examples
of communication from state programs and
Stroke Addendum to the Communication
Guide (wwwcdcgovdhdsplibraryheart_
stroke_guideindexhtm)
For additional information please visit the CDC
website at wwwcdcgovdhdsp or contact the
Division for Heart Disease and Stroke Prevention
Program Development and Services Branch at
(770) 488-2424
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
17
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
State Heart Disease and Stroke Prevention Program Funding Opportunity Announcement DP07-704 At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
18
Introduction The Funding Opportunity Announcement
(FOA) DP07-704 At-A-Glance provides important
information to assist programs funded under this
announcement to deliver their program as intended
The At-A-Glance highlights aspects of FOA DP07-704
important for all funded programs including
the following
bull Overview of the National Heart Disease and
Stroke Prevention Program
bull Heart Disease and Stroke Prevention State
Program roles
bull Performance measures for Capacity Building Basic
Implementation Optional Funding for Capacity
Building programs and Stroke Networks
bull Funded program reporting requirements
bull Budgetfunding guidance
bull National and administrative policy requirements
If a program needs a copy of the full document
it should contact its project officer (see Program
Contacts section of the full National Heart Disease
and Stroke Prevention Program Staff Orientation
Manual) to fulfill that request
Section 1 Background In 1998 the US Congress provided funding for
CDC to initiate a national state-based cardiovascular
health program The Senate Appropriations
Committee in 2005 encouraged CDC to create the
Division for Heart Disease and Stroke Prevention and
increased resources enabling CDC to reach 32 of the
50 states and the District of Columbia with funding
for heart disease and stroke prevention As of 2008
the Heart Disease and Stroke Prevention (HDSP)
program funds 41 states and the District of Columbia
As the Division for Heart Disease and Stroke
Prevention developed so did the focus of the State
HDSP Program Focusing on the six program priority
areas (noted below) should impact morbidity and
mortality of these diseases State programs should
increase heart disease and stroke prevention policies
and systems change with the potential to impact
the general population and Priority Populations
(see Prevention Works CDC Strategies for a Heart-
healthy and Stroke-free America wwwCDCgov
dhdsplibrary) For more information on the CDC
State HDSP Program visit wwwcdcgovdhdspState_
programindexhtm
A Public Health Action Plan to Prevent Heart Disease
and Stroke (see wwwCDCgovdhdsplibrary)
documents the multiple intervention opportunities
for preventing heart disease and stroke It is
important to work with partners collaboratively in
leveraging resources to address the multiple risk
factors that are associated with these diseases
Announcement DP07-704 supports program
components considered essential to enhancing
the leadership of state health departments in
heart disease and stroke prevention It provides
for the funding of capacity building and basic
implementation programs as well as projects such as
the Optional Funding for Capacity Building Programs
and Stroke Networks
A capacity building program develops the foundation
for a comprehensive cardiovascular disease prevention
program through such activities as partnership
development definition of the burden and
development of a state plan A basic implementation
program enhances capacity building activities and
implements disseminates and evaluates intervention
activities that address the state plan objectives and the
CDC program priority areas 1ndash6
1 Increase control of high blood pressure primarily
in adults and older adults
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19
2 Increase control of high blood cholesterol
primarily in adults and older adults
3 Increase knowledge of signs and symptoms for
heart attack and stroke and the importance of
calling 9-1-1
4 Improve emergency response
5 Improve quality of heart disease and stroke care
6 Eliminate disparities in terms of race ethnicity
gender geography or socioeconomic status
Optional Funding for Capacity Building Programs
provides support to programs to implement an
evidence-based or promising practice demonstration
project that addresses the CDC program priority
areas 1ndash6
Stroke Networks support a state health department to
increase stroke prevention activities across a group of
three to six contiguous member states with emphasis
on increasing awareness and implementing priority
policy or systems changes across the states
The State HDSP Program is anchored on the
framework of the Socio-ecological Model which
conceptualized the influences of individual
behaviors family and social relationships community
and environmental effects and societal influences
such as policies on health status In order to
promote significant impact for improving the health
of the population interventions should focus on
implementing policy and systems change strategies
that support heart disease and stroke prevention
Policy change can be addressed through a) public
policy (eg establishing certification for hospital-
based stroke centers) or b) organizational policy
(eg businesses providing health benefits plans
that cover preventive services that include blood
pressure control)
System changes are encouraged in three settings
worksites health care and communities An
example of a systems change is when a health
care setting implements electronic records and
patient care management systems that improve the
quality of health care Interventions within systems
are encouraged at the highest level possiblemdashfor
example activities with business coalitions rather
than individual worksites and with managed care
organizations (MCOs) and state medical associations
rather than individual health care sites or physicians
By working at higher levels to affect systems change
states can impact larger segments of the population
Education and awareness efforts to enhance
public understanding and promote actions related
to cardiovascular diseases and the risk factors of
high blood pressure and high cholesterol signs
and symptoms of heart attack and stroke and the
need to call 9-1-1 are also components of capacity
enhancement
An overarching goal of the State HDSP Program
is to address disparities in heart disease and
stroke and the related risk factors using policy and
systems change strategies Based on disparities
(eg raceethnicity gender geographic geography
socioeconomic status) in mortality access to care
or burden of risk factors the State HDSP Program
should identify Priority Populations and implement
interventions to reach those Priority Populations
No one organization will be able to address the
prevention of heart disease and stroke It will require
many organizations working in collaboration if
progress is to be made in accomplishing the Healthy
People 2010 Objectives Collaboration is defined
by the Wilder Foundation as ldquoa mutually beneficial
and well-defined relationship entered into by two
or more organizations to achieve common goals
The relationship includes a commitment to mutual
relationships and goals a jointly developed structure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
20
and shared responsibility mutual authority and
accountability for success and sharing of resources
and rewardsrdquo Developing and maintaining
strategic partnerships are key to the leveraging of
skills and resources to prevent heart disease and
stroke in a comprehensive way The State HDSP
Program has two major roles related to partners
The first is to convene or facilitate collaboration
to develop and implement a comprehensive state
plan and intervention implementation strategies
that addresses heart disease stroke and related
risk factors The second is to develop strategies to
leverage resources and coordinate interventions
with partners that address the six program
priority areas
A logic model has been developed to describe
the State HDSP Program as intended by the CDC
funding to state health departments (see following
page) The model depicts relationships and actions
(eg links between environment and policy
change and individual-level behavioral change)
that are expected to culminate in reduction in
heart disease and stroke
The CDC and state activities are outlined in terms
of capacity building surveillancemonitoring
and interventions Both CDC and state activities
influence changes that lead to short-term
outcomes such as development of a work plan
and strategies for system-level changes effective
implementation of interventions and action by
target audiences and change agents (those who are
in the position to influence policies and systems
such as hospital administrators and MCO decision
makers) These activities and outcomes result in
changes in policy and environmental supports
which in turn influence behavior changes and
improve health status Ultimately these changes
decrease premature death and disability and
eliminate cardiovascular disparities between
general and Priority Populations
The State HDSP logic model also is a tool to guide
program evaluation By identifying the steps
necessary to reach intended outcomes the logic
model provides guidance in evaluating the short and
intermediate outcomes of the program
State evaluation efforts should relate to the National
HDSP Program logic model or to a logic model that
the state develops that complements the national
model and the required program recipient activities
The logic model can also be seen in the CDC
Evaluation Framework for Heart Disease and Stroke
Prevention State Programs at wwwcdcgovdhdsp
Section 2 National Heart Disease and Stroke Prevention State Program Roles In A Public Health Action Plan to Prevent Heart
Disease and Stroke there are four major goals which
are based on Healthy People 2010
Goal 1 Prevention of risk factors
Goal 2 Detection and treatment of risk factors
Goal 3 Early identification and treatment of heart
attacks and strokes
Goal 4 Prevention of recurrent cardiovascular events
CDC-funded State HDSP Programs have a direct
impact on Goals 2 3 and 4 by addressing HDSP
program priority areas 1ndash6 (see Background section)
HDSP programs have a supportive role with other
state health department programs and partners in
addressing Goal 1 Efforts to address Goal 1 related
to tobacco use diabetes obesity poor nutrition
physical inactivity and schools as a worksite should
be done through a supportive or collaborative role
with the state WISEWOMAN diabetes tobacco
nutrition physical activity or coordinated school
health programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
bull State HDSP Programs are encouraged to
coordinate with other programs in ways that
1 Address Goal 1 (eg State HDSP and Nutrition
Programs identify primary prevention messages
related to cholesterol and salt to be included in Nushy
trition Programs where appropriate State HDSP and
Tobacco Programs collaborate to promote use of
state tobacco quit lines State HDSP Program refers
managed care organizations to materials developed
by the Parks and Recreation Department and
Physical Activity Program on safe places to exercise
National HDSP Program Logic Model
State HDSP and WISEWOMAN Programs collaborate
to create systems for educating health care providers
on guidelines focused on risk factor prevention)
2 Enhance inclusion of key messages in the work
of related programs (eg State HDSP Program
works to implement JNC7 guidelines which
include referral to nutrition counseling the
WISEWOMAN Program incorporates education on
signs and symptoms of heart disease and stroke
into ongoing activities the State HDSP Program
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and system change supports
Level bull State bull Local
Settings bull Community bull Health care bull Worksite
Context bull Priority
Populations bull General
populations
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective intervention
implemented focused on
settings and Priority Populations
Change agents
take action
Activate intended audiences
Capa
city B
uildin
gSu
rveil
lance
Inter
vent
ions
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
21
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
11
were submitted to the National Quality Forum in
March 2008 and 8 of the 10 were adopted This
endorsement of the Consensus Stroke Performance
Measures has paved the way for adoption of
these measures by the Centers for Medicare
and Medicaid Services for quality reporting and
meaningful use
Quarterly Data Reports With the implementation
of the Consensus Stroke Performance Measures in
January 2008 CDC began providing states with
quarterly data reports on the measures These
reports provide each state with a summary of its
data on ischemic stroke hemorrhagic stroke and
transient ischemic attacks as well as aggregate data
for all states in the Coverdell Registry program
Applied Research and Evaluation Branch
Building an Economic Evaluation Research Agenda
Based on program needs and research gaps in heart
disease and stroke prevention the Applied Research
and Evaluation Branch developed an agenda to
guide economic research on 1) economic burden
of cardiovascular diseases and cost-effectiveness of
their control 2) economic value of DHDSP-funded
and other state prevention programs 3) CDCrsquos
Internet-based clearinghouse for information on
the economics of cardiovascular diseases and 4)
developing partnerships in economic research to
increase the impact of such research
Stroke Awareness Signs and Symptoms Awareness Campaigns
To provide guidance for state programs a review of
current research on stroke awareness campaigns was
undertaken to identify evidence to support the most
appropriate ways to increase knowledge of signs and
symptoms for stroke the importance of calling 9-1-1
and relationships between the educational campaigns
and outcomes related to awareness of stroke signs
and symptoms
The literature review and synthesis of current
research on stroke awareness campaigns resulted
in the following dissemination activities
bull Development of a fact sheet for state programs on
literature review findings and considerations for
statesrsquo current activities related to stroke awareness
messages including direct education and tools
available to facilitate campaign development
bull Poster presentation at the 2008 National
Conference on Health Communication Marketing
and Media on evaluation guidance for stroke
awareness campaigns The presentation outlined
specific information for states and communities on
how to strengthen the effectiveness and outcome
evaluation of their stroke awareness campaigns
bull Presentation at the 2008 National Heart Disease
and Stroke Prevention Training Institute about
evidence and research on communication and
media campaigns impact considerations of cost
opportunities for partnering and evaluating
results
Comprehensive and Core Indicators
DHDSP released a set of core indicators for
hypertension as part of a comprehensive evidence-
based set of indicators to guide state heart disease
and stroke prevention programs in evaluating their
efforts State health departments received related
key guidance documents training at the National
Heart Disease and Stroke Prevention Training
Institute and a series of follow-up trainings
Indicators are presented in a Consumer Reports
format and rated on multiple dimensions such as
strength of scientific evidence feasibility of data
collection and face validity
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
12
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkitmdash Evaluation Results
CDC worked with the American Institutes for
Research (AIR) to conduct an evaluation of the
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit State health departments
(SHDs) were trained to use the toolkit to promote
state employer-based initiatives on workplace efforts
for heart disease and stroke prevention
From 2005 to 2007 all the SHDs received copies of
the toolkit and were invited to attend training sessions
(one seminar five webinars and three consultations)
To evaluate the usefulness of the toolkit materials
and obtain recommendations two focus groups with
business leaders and Web-based surveys of the SHDs
were conducted In 2006 all 50 states and the District
of Columbia completed the baseline and in 2008 40
states completed the follow-up
Of the 40 SHDs that completed both waves of the
survey the proportion that reported engaging in
employer-based initiatives significantly increased
from 65 percent to 725 percent during the period
examined despite a reported reduction in staff and
limited appropriations About 90 percent of the
SHDs that responded to the 2008 survey are now
working with employers to promote comprehensive
heart disease and stroke prevention programs
disseminate best practices establish employer-
oriented partnerships participate in seminars for
employers and provide business leaders with
resources Partnerships with employer groups or
business coalitions have focused on worksite policy
changes health promotion and education and
worksite surveillance and assessments In parallel
to these experiences the SHDs have increased their
overall level of confidence in their knowledge and
skills Most of the SHDs (61 percent) agreed that
the CDC trainings and consultations helped them
improve their heart disease and stroke prevention
programs and use the toolkit more effectively
Participation in the trainings was positively associated
with engagement in worksite health promotion and
education The SHDs that received federal funding
had significantly higher participation in macro-
marketing activities reaching employers through
business coalitions associations task forces and
champions and were more likely to establish
partnerships with employer groups and government
agencies
The Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit is available at wwwcdc
govdhdsplibrarytoolkitindexhtm
The Branch also provides economics support to
the Division and partners by documenting costs of
cardiovascular diseases and their risk factors and
identifying cost-effective interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
13
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
National Heart Disease and Stroke Prevention Program Overview
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
14
u Blood pressure Prevent and control high blood Program Overview pressure reduce sodium intake
bull In 1998 the US Congress provided funding
for CDC to initiate a national state-based Heart
Disease and Stroke Prevention (HDSP) program in
eight states
bull CDC funds programs in 41 states and the
District of Columbia Twenty-eight are capacity
building (planning) programs and 14 are basic
implementation (intervention) programs
bull Capacity Building Programs Alabama
Alaska Arizona California Colorado Connecticut
District of Columbia Hawaii Idaho Illinois Iowa
Kansas Kentucky Louisiana Maryland Michigan
Minnesota Mississippi Nebraska New Jersey
North Dakota Ohio Oklahoma Oregon Rhode
Island Tennessee Texas and Wisconsin
bull Basic Implementation Programs Arkansas
Florida Georgia Maine Massachusetts Missouri
Montana New York North Carolina South
Carolina Utah Virginia Washington and West
Virginia
National Heart Disease and Stroke Prevention Program Goals bull Enhance state capacity to plan implement track
and sustain population-based interventions to
address heart disease stroke and related risk
factors Focus program efforts on population-
based policy and systems change strategies to
impact the ldquoABCSrdquo of heart disease and stroke
prevention
u Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
u Cholesterol Prevent and control high
cholesterol
u Smoking Increase the number of smokers
counseled to quit and referred to quitlines by
health care workers increase availability of no
or low-cost cessation products and collaborate
with efforts to increase the percentage of the
population protected by smoke-free air laws
and regulations
To a lesser extent state HDSP programs work to
improve emergency response and quality of acute
care systems
State HDSP programs work to eliminate health
disparities in priority populations (ie groups with
increased burden or need based on race ethnicity
gender geography or socioeconomic status) as an
overarching principle
bull Collaborate with chronic disease programs (eg
those focusing on tobacco diabetes physical
inactivity poor nutrition and obesityoverweight)
and partners to develop and integrate population-
based strategies to prevent heart disease and
stroke
bull Promote cardiovascular health in health care
worksite and community settings through policy
and systems changes
bull Identify and evaluate promising practices to
address heart disease and stroke
bull Conduct surveillance of heart disease stroke
and related risk factors
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
15
u
u
Key Responsibilities of State Capacity Building Programs bull Facilitate collaboration with public- and private-
sector partners such as not-for-profit health
agencies health systems organizations emergency
response agencies federally funded health centers
businesses priority population organizations and
voluntary health organizations
bull Document the state burden of heart disease
stroke and related risk factors
bull Develop plans for population-based strategies
for preventing heart disease and stroke among
general and Priority Populations
bull Develop a comprehensive state HDSP plan
bull Develop an HDSP program logic model and
evaluation plan
bull Assess assets and gaps in state policy and systems
related to HDSP in health care worksite and
community settings
Key Responsibilities of State Basic Implementation Programs bull Enhance all capacity-building program activities
bull Implement and evaluate policy systems change
and educational interventions that address the
six HDSP program priority areas in health care
worksite and community settings
bull Provide training and technical assistance to
public health and health care professionals and
partners to support policy and system changes
that will encourage heart disease and stroke
prevention
How CDC Assists State Heart Disease and Stroke Prevention Programs bull Provides training technical assistance and
funding
bull Funds applied research on heart disease and
stroke interventions and elimination of disparities
that is relevant to state programs
bull Identifies and disseminates science-based
promising practices
bull Partners with national organizations to help states
address prevention of heart disease and stroke
bull Facilitates collaborations with other state chronic
disease programs or activities that address risk
factors populations or settings related to heart
disease and stroke prevention and program
priority areas
bull Develops and disseminates publications and tools
such as
u CDCynergy a CD-ROM-based tool for
planning health communication interventions
State Heart Disease and Stroke Prevention
Program Evaluation Framework (wwwcdc
govdhdsplibraryevaluation_framework
indexhtm) a document providing guidance
on systematic ways to measure the success of
public health programs and on logic model
development
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping an
Evaluation Plan (wwwcdcgovDHDSPstate_
programevaluation_guidesevaluation_plan
htm) a document providing guidance on the
development of evaluation activities to help
programs identify required staff time and
resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
16
u
u
u
u
u
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping and
Using a Logic Model (wwwcdcgovDHDSP
state_programevaluation_guideslogic_model
htm) a document providing guidance on
the development and use of logic models as
planning and evaluation tools
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashWriting SMART
Objectives (wwwcdcgovDHDSPstate_
programevaluation_guidessmart_objectives
htm) a document providing guidance to
states on the development of realistic and
measurable objectives
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit (wwwcdcgov
dhdsplibrarytoolkitindexhtm) a document
that provides information materials and
tools that state programs can reference and
distribute to businesses primarily through
employer and professional organizations
Heart Disease and Stroke Interactive Maps
(wwwcdcgovdhdsplibrarymapsstatemaps
htm) which present heart disease and stroke
mortality rates by county for the state racial
ethnic group and gender of the userrsquos choice
A Communication Guide for Policy and
Environmental Change (wwwcdcgovdhdsp
libraryheart_stroke_guideindexhtm) which
includes information references and examples
of communication from state programs and
Stroke Addendum to the Communication
Guide (wwwcdcgovdhdsplibraryheart_
stroke_guideindexhtm)
For additional information please visit the CDC
website at wwwcdcgovdhdsp or contact the
Division for Heart Disease and Stroke Prevention
Program Development and Services Branch at
(770) 488-2424
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
17
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
State Heart Disease and Stroke Prevention Program Funding Opportunity Announcement DP07-704 At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
18
Introduction The Funding Opportunity Announcement
(FOA) DP07-704 At-A-Glance provides important
information to assist programs funded under this
announcement to deliver their program as intended
The At-A-Glance highlights aspects of FOA DP07-704
important for all funded programs including
the following
bull Overview of the National Heart Disease and
Stroke Prevention Program
bull Heart Disease and Stroke Prevention State
Program roles
bull Performance measures for Capacity Building Basic
Implementation Optional Funding for Capacity
Building programs and Stroke Networks
bull Funded program reporting requirements
bull Budgetfunding guidance
bull National and administrative policy requirements
If a program needs a copy of the full document
it should contact its project officer (see Program
Contacts section of the full National Heart Disease
and Stroke Prevention Program Staff Orientation
Manual) to fulfill that request
Section 1 Background In 1998 the US Congress provided funding for
CDC to initiate a national state-based cardiovascular
health program The Senate Appropriations
Committee in 2005 encouraged CDC to create the
Division for Heart Disease and Stroke Prevention and
increased resources enabling CDC to reach 32 of the
50 states and the District of Columbia with funding
for heart disease and stroke prevention As of 2008
the Heart Disease and Stroke Prevention (HDSP)
program funds 41 states and the District of Columbia
As the Division for Heart Disease and Stroke
Prevention developed so did the focus of the State
HDSP Program Focusing on the six program priority
areas (noted below) should impact morbidity and
mortality of these diseases State programs should
increase heart disease and stroke prevention policies
and systems change with the potential to impact
the general population and Priority Populations
(see Prevention Works CDC Strategies for a Heart-
healthy and Stroke-free America wwwCDCgov
dhdsplibrary) For more information on the CDC
State HDSP Program visit wwwcdcgovdhdspState_
programindexhtm
A Public Health Action Plan to Prevent Heart Disease
and Stroke (see wwwCDCgovdhdsplibrary)
documents the multiple intervention opportunities
for preventing heart disease and stroke It is
important to work with partners collaboratively in
leveraging resources to address the multiple risk
factors that are associated with these diseases
Announcement DP07-704 supports program
components considered essential to enhancing
the leadership of state health departments in
heart disease and stroke prevention It provides
for the funding of capacity building and basic
implementation programs as well as projects such as
the Optional Funding for Capacity Building Programs
and Stroke Networks
A capacity building program develops the foundation
for a comprehensive cardiovascular disease prevention
program through such activities as partnership
development definition of the burden and
development of a state plan A basic implementation
program enhances capacity building activities and
implements disseminates and evaluates intervention
activities that address the state plan objectives and the
CDC program priority areas 1ndash6
1 Increase control of high blood pressure primarily
in adults and older adults
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19
2 Increase control of high blood cholesterol
primarily in adults and older adults
3 Increase knowledge of signs and symptoms for
heart attack and stroke and the importance of
calling 9-1-1
4 Improve emergency response
5 Improve quality of heart disease and stroke care
6 Eliminate disparities in terms of race ethnicity
gender geography or socioeconomic status
Optional Funding for Capacity Building Programs
provides support to programs to implement an
evidence-based or promising practice demonstration
project that addresses the CDC program priority
areas 1ndash6
Stroke Networks support a state health department to
increase stroke prevention activities across a group of
three to six contiguous member states with emphasis
on increasing awareness and implementing priority
policy or systems changes across the states
The State HDSP Program is anchored on the
framework of the Socio-ecological Model which
conceptualized the influences of individual
behaviors family and social relationships community
and environmental effects and societal influences
such as policies on health status In order to
promote significant impact for improving the health
of the population interventions should focus on
implementing policy and systems change strategies
that support heart disease and stroke prevention
Policy change can be addressed through a) public
policy (eg establishing certification for hospital-
based stroke centers) or b) organizational policy
(eg businesses providing health benefits plans
that cover preventive services that include blood
pressure control)
System changes are encouraged in three settings
worksites health care and communities An
example of a systems change is when a health
care setting implements electronic records and
patient care management systems that improve the
quality of health care Interventions within systems
are encouraged at the highest level possiblemdashfor
example activities with business coalitions rather
than individual worksites and with managed care
organizations (MCOs) and state medical associations
rather than individual health care sites or physicians
By working at higher levels to affect systems change
states can impact larger segments of the population
Education and awareness efforts to enhance
public understanding and promote actions related
to cardiovascular diseases and the risk factors of
high blood pressure and high cholesterol signs
and symptoms of heart attack and stroke and the
need to call 9-1-1 are also components of capacity
enhancement
An overarching goal of the State HDSP Program
is to address disparities in heart disease and
stroke and the related risk factors using policy and
systems change strategies Based on disparities
(eg raceethnicity gender geographic geography
socioeconomic status) in mortality access to care
or burden of risk factors the State HDSP Program
should identify Priority Populations and implement
interventions to reach those Priority Populations
No one organization will be able to address the
prevention of heart disease and stroke It will require
many organizations working in collaboration if
progress is to be made in accomplishing the Healthy
People 2010 Objectives Collaboration is defined
by the Wilder Foundation as ldquoa mutually beneficial
and well-defined relationship entered into by two
or more organizations to achieve common goals
The relationship includes a commitment to mutual
relationships and goals a jointly developed structure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
20
and shared responsibility mutual authority and
accountability for success and sharing of resources
and rewardsrdquo Developing and maintaining
strategic partnerships are key to the leveraging of
skills and resources to prevent heart disease and
stroke in a comprehensive way The State HDSP
Program has two major roles related to partners
The first is to convene or facilitate collaboration
to develop and implement a comprehensive state
plan and intervention implementation strategies
that addresses heart disease stroke and related
risk factors The second is to develop strategies to
leverage resources and coordinate interventions
with partners that address the six program
priority areas
A logic model has been developed to describe
the State HDSP Program as intended by the CDC
funding to state health departments (see following
page) The model depicts relationships and actions
(eg links between environment and policy
change and individual-level behavioral change)
that are expected to culminate in reduction in
heart disease and stroke
The CDC and state activities are outlined in terms
of capacity building surveillancemonitoring
and interventions Both CDC and state activities
influence changes that lead to short-term
outcomes such as development of a work plan
and strategies for system-level changes effective
implementation of interventions and action by
target audiences and change agents (those who are
in the position to influence policies and systems
such as hospital administrators and MCO decision
makers) These activities and outcomes result in
changes in policy and environmental supports
which in turn influence behavior changes and
improve health status Ultimately these changes
decrease premature death and disability and
eliminate cardiovascular disparities between
general and Priority Populations
The State HDSP logic model also is a tool to guide
program evaluation By identifying the steps
necessary to reach intended outcomes the logic
model provides guidance in evaluating the short and
intermediate outcomes of the program
State evaluation efforts should relate to the National
HDSP Program logic model or to a logic model that
the state develops that complements the national
model and the required program recipient activities
The logic model can also be seen in the CDC
Evaluation Framework for Heart Disease and Stroke
Prevention State Programs at wwwcdcgovdhdsp
Section 2 National Heart Disease and Stroke Prevention State Program Roles In A Public Health Action Plan to Prevent Heart
Disease and Stroke there are four major goals which
are based on Healthy People 2010
Goal 1 Prevention of risk factors
Goal 2 Detection and treatment of risk factors
Goal 3 Early identification and treatment of heart
attacks and strokes
Goal 4 Prevention of recurrent cardiovascular events
CDC-funded State HDSP Programs have a direct
impact on Goals 2 3 and 4 by addressing HDSP
program priority areas 1ndash6 (see Background section)
HDSP programs have a supportive role with other
state health department programs and partners in
addressing Goal 1 Efforts to address Goal 1 related
to tobacco use diabetes obesity poor nutrition
physical inactivity and schools as a worksite should
be done through a supportive or collaborative role
with the state WISEWOMAN diabetes tobacco
nutrition physical activity or coordinated school
health programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
bull State HDSP Programs are encouraged to
coordinate with other programs in ways that
1 Address Goal 1 (eg State HDSP and Nutrition
Programs identify primary prevention messages
related to cholesterol and salt to be included in Nushy
trition Programs where appropriate State HDSP and
Tobacco Programs collaborate to promote use of
state tobacco quit lines State HDSP Program refers
managed care organizations to materials developed
by the Parks and Recreation Department and
Physical Activity Program on safe places to exercise
National HDSP Program Logic Model
State HDSP and WISEWOMAN Programs collaborate
to create systems for educating health care providers
on guidelines focused on risk factor prevention)
2 Enhance inclusion of key messages in the work
of related programs (eg State HDSP Program
works to implement JNC7 guidelines which
include referral to nutrition counseling the
WISEWOMAN Program incorporates education on
signs and symptoms of heart disease and stroke
into ongoing activities the State HDSP Program
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and system change supports
Level bull State bull Local
Settings bull Community bull Health care bull Worksite
Context bull Priority
Populations bull General
populations
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective intervention
implemented focused on
settings and Priority Populations
Change agents
take action
Activate intended audiences
Capa
city B
uildin
gSu
rveil
lance
Inter
vent
ions
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
21
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
12
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkitmdash Evaluation Results
CDC worked with the American Institutes for
Research (AIR) to conduct an evaluation of the
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit State health departments
(SHDs) were trained to use the toolkit to promote
state employer-based initiatives on workplace efforts
for heart disease and stroke prevention
From 2005 to 2007 all the SHDs received copies of
the toolkit and were invited to attend training sessions
(one seminar five webinars and three consultations)
To evaluate the usefulness of the toolkit materials
and obtain recommendations two focus groups with
business leaders and Web-based surveys of the SHDs
were conducted In 2006 all 50 states and the District
of Columbia completed the baseline and in 2008 40
states completed the follow-up
Of the 40 SHDs that completed both waves of the
survey the proportion that reported engaging in
employer-based initiatives significantly increased
from 65 percent to 725 percent during the period
examined despite a reported reduction in staff and
limited appropriations About 90 percent of the
SHDs that responded to the 2008 survey are now
working with employers to promote comprehensive
heart disease and stroke prevention programs
disseminate best practices establish employer-
oriented partnerships participate in seminars for
employers and provide business leaders with
resources Partnerships with employer groups or
business coalitions have focused on worksite policy
changes health promotion and education and
worksite surveillance and assessments In parallel
to these experiences the SHDs have increased their
overall level of confidence in their knowledge and
skills Most of the SHDs (61 percent) agreed that
the CDC trainings and consultations helped them
improve their heart disease and stroke prevention
programs and use the toolkit more effectively
Participation in the trainings was positively associated
with engagement in worksite health promotion and
education The SHDs that received federal funding
had significantly higher participation in macro-
marketing activities reaching employers through
business coalitions associations task forces and
champions and were more likely to establish
partnerships with employer groups and government
agencies
The Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit is available at wwwcdc
govdhdsplibrarytoolkitindexhtm
The Branch also provides economics support to
the Division and partners by documenting costs of
cardiovascular diseases and their risk factors and
identifying cost-effective interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
13
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
National Heart Disease and Stroke Prevention Program Overview
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
14
u Blood pressure Prevent and control high blood Program Overview pressure reduce sodium intake
bull In 1998 the US Congress provided funding
for CDC to initiate a national state-based Heart
Disease and Stroke Prevention (HDSP) program in
eight states
bull CDC funds programs in 41 states and the
District of Columbia Twenty-eight are capacity
building (planning) programs and 14 are basic
implementation (intervention) programs
bull Capacity Building Programs Alabama
Alaska Arizona California Colorado Connecticut
District of Columbia Hawaii Idaho Illinois Iowa
Kansas Kentucky Louisiana Maryland Michigan
Minnesota Mississippi Nebraska New Jersey
North Dakota Ohio Oklahoma Oregon Rhode
Island Tennessee Texas and Wisconsin
bull Basic Implementation Programs Arkansas
Florida Georgia Maine Massachusetts Missouri
Montana New York North Carolina South
Carolina Utah Virginia Washington and West
Virginia
National Heart Disease and Stroke Prevention Program Goals bull Enhance state capacity to plan implement track
and sustain population-based interventions to
address heart disease stroke and related risk
factors Focus program efforts on population-
based policy and systems change strategies to
impact the ldquoABCSrdquo of heart disease and stroke
prevention
u Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
u Cholesterol Prevent and control high
cholesterol
u Smoking Increase the number of smokers
counseled to quit and referred to quitlines by
health care workers increase availability of no
or low-cost cessation products and collaborate
with efforts to increase the percentage of the
population protected by smoke-free air laws
and regulations
To a lesser extent state HDSP programs work to
improve emergency response and quality of acute
care systems
State HDSP programs work to eliminate health
disparities in priority populations (ie groups with
increased burden or need based on race ethnicity
gender geography or socioeconomic status) as an
overarching principle
bull Collaborate with chronic disease programs (eg
those focusing on tobacco diabetes physical
inactivity poor nutrition and obesityoverweight)
and partners to develop and integrate population-
based strategies to prevent heart disease and
stroke
bull Promote cardiovascular health in health care
worksite and community settings through policy
and systems changes
bull Identify and evaluate promising practices to
address heart disease and stroke
bull Conduct surveillance of heart disease stroke
and related risk factors
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
15
u
u
Key Responsibilities of State Capacity Building Programs bull Facilitate collaboration with public- and private-
sector partners such as not-for-profit health
agencies health systems organizations emergency
response agencies federally funded health centers
businesses priority population organizations and
voluntary health organizations
bull Document the state burden of heart disease
stroke and related risk factors
bull Develop plans for population-based strategies
for preventing heart disease and stroke among
general and Priority Populations
bull Develop a comprehensive state HDSP plan
bull Develop an HDSP program logic model and
evaluation plan
bull Assess assets and gaps in state policy and systems
related to HDSP in health care worksite and
community settings
Key Responsibilities of State Basic Implementation Programs bull Enhance all capacity-building program activities
bull Implement and evaluate policy systems change
and educational interventions that address the
six HDSP program priority areas in health care
worksite and community settings
bull Provide training and technical assistance to
public health and health care professionals and
partners to support policy and system changes
that will encourage heart disease and stroke
prevention
How CDC Assists State Heart Disease and Stroke Prevention Programs bull Provides training technical assistance and
funding
bull Funds applied research on heart disease and
stroke interventions and elimination of disparities
that is relevant to state programs
bull Identifies and disseminates science-based
promising practices
bull Partners with national organizations to help states
address prevention of heart disease and stroke
bull Facilitates collaborations with other state chronic
disease programs or activities that address risk
factors populations or settings related to heart
disease and stroke prevention and program
priority areas
bull Develops and disseminates publications and tools
such as
u CDCynergy a CD-ROM-based tool for
planning health communication interventions
State Heart Disease and Stroke Prevention
Program Evaluation Framework (wwwcdc
govdhdsplibraryevaluation_framework
indexhtm) a document providing guidance
on systematic ways to measure the success of
public health programs and on logic model
development
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping an
Evaluation Plan (wwwcdcgovDHDSPstate_
programevaluation_guidesevaluation_plan
htm) a document providing guidance on the
development of evaluation activities to help
programs identify required staff time and
resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
16
u
u
u
u
u
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping and
Using a Logic Model (wwwcdcgovDHDSP
state_programevaluation_guideslogic_model
htm) a document providing guidance on
the development and use of logic models as
planning and evaluation tools
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashWriting SMART
Objectives (wwwcdcgovDHDSPstate_
programevaluation_guidessmart_objectives
htm) a document providing guidance to
states on the development of realistic and
measurable objectives
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit (wwwcdcgov
dhdsplibrarytoolkitindexhtm) a document
that provides information materials and
tools that state programs can reference and
distribute to businesses primarily through
employer and professional organizations
Heart Disease and Stroke Interactive Maps
(wwwcdcgovdhdsplibrarymapsstatemaps
htm) which present heart disease and stroke
mortality rates by county for the state racial
ethnic group and gender of the userrsquos choice
A Communication Guide for Policy and
Environmental Change (wwwcdcgovdhdsp
libraryheart_stroke_guideindexhtm) which
includes information references and examples
of communication from state programs and
Stroke Addendum to the Communication
Guide (wwwcdcgovdhdsplibraryheart_
stroke_guideindexhtm)
For additional information please visit the CDC
website at wwwcdcgovdhdsp or contact the
Division for Heart Disease and Stroke Prevention
Program Development and Services Branch at
(770) 488-2424
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17
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
State Heart Disease and Stroke Prevention Program Funding Opportunity Announcement DP07-704 At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
18
Introduction The Funding Opportunity Announcement
(FOA) DP07-704 At-A-Glance provides important
information to assist programs funded under this
announcement to deliver their program as intended
The At-A-Glance highlights aspects of FOA DP07-704
important for all funded programs including
the following
bull Overview of the National Heart Disease and
Stroke Prevention Program
bull Heart Disease and Stroke Prevention State
Program roles
bull Performance measures for Capacity Building Basic
Implementation Optional Funding for Capacity
Building programs and Stroke Networks
bull Funded program reporting requirements
bull Budgetfunding guidance
bull National and administrative policy requirements
If a program needs a copy of the full document
it should contact its project officer (see Program
Contacts section of the full National Heart Disease
and Stroke Prevention Program Staff Orientation
Manual) to fulfill that request
Section 1 Background In 1998 the US Congress provided funding for
CDC to initiate a national state-based cardiovascular
health program The Senate Appropriations
Committee in 2005 encouraged CDC to create the
Division for Heart Disease and Stroke Prevention and
increased resources enabling CDC to reach 32 of the
50 states and the District of Columbia with funding
for heart disease and stroke prevention As of 2008
the Heart Disease and Stroke Prevention (HDSP)
program funds 41 states and the District of Columbia
As the Division for Heart Disease and Stroke
Prevention developed so did the focus of the State
HDSP Program Focusing on the six program priority
areas (noted below) should impact morbidity and
mortality of these diseases State programs should
increase heart disease and stroke prevention policies
and systems change with the potential to impact
the general population and Priority Populations
(see Prevention Works CDC Strategies for a Heart-
healthy and Stroke-free America wwwCDCgov
dhdsplibrary) For more information on the CDC
State HDSP Program visit wwwcdcgovdhdspState_
programindexhtm
A Public Health Action Plan to Prevent Heart Disease
and Stroke (see wwwCDCgovdhdsplibrary)
documents the multiple intervention opportunities
for preventing heart disease and stroke It is
important to work with partners collaboratively in
leveraging resources to address the multiple risk
factors that are associated with these diseases
Announcement DP07-704 supports program
components considered essential to enhancing
the leadership of state health departments in
heart disease and stroke prevention It provides
for the funding of capacity building and basic
implementation programs as well as projects such as
the Optional Funding for Capacity Building Programs
and Stroke Networks
A capacity building program develops the foundation
for a comprehensive cardiovascular disease prevention
program through such activities as partnership
development definition of the burden and
development of a state plan A basic implementation
program enhances capacity building activities and
implements disseminates and evaluates intervention
activities that address the state plan objectives and the
CDC program priority areas 1ndash6
1 Increase control of high blood pressure primarily
in adults and older adults
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19
2 Increase control of high blood cholesterol
primarily in adults and older adults
3 Increase knowledge of signs and symptoms for
heart attack and stroke and the importance of
calling 9-1-1
4 Improve emergency response
5 Improve quality of heart disease and stroke care
6 Eliminate disparities in terms of race ethnicity
gender geography or socioeconomic status
Optional Funding for Capacity Building Programs
provides support to programs to implement an
evidence-based or promising practice demonstration
project that addresses the CDC program priority
areas 1ndash6
Stroke Networks support a state health department to
increase stroke prevention activities across a group of
three to six contiguous member states with emphasis
on increasing awareness and implementing priority
policy or systems changes across the states
The State HDSP Program is anchored on the
framework of the Socio-ecological Model which
conceptualized the influences of individual
behaviors family and social relationships community
and environmental effects and societal influences
such as policies on health status In order to
promote significant impact for improving the health
of the population interventions should focus on
implementing policy and systems change strategies
that support heart disease and stroke prevention
Policy change can be addressed through a) public
policy (eg establishing certification for hospital-
based stroke centers) or b) organizational policy
(eg businesses providing health benefits plans
that cover preventive services that include blood
pressure control)
System changes are encouraged in three settings
worksites health care and communities An
example of a systems change is when a health
care setting implements electronic records and
patient care management systems that improve the
quality of health care Interventions within systems
are encouraged at the highest level possiblemdashfor
example activities with business coalitions rather
than individual worksites and with managed care
organizations (MCOs) and state medical associations
rather than individual health care sites or physicians
By working at higher levels to affect systems change
states can impact larger segments of the population
Education and awareness efforts to enhance
public understanding and promote actions related
to cardiovascular diseases and the risk factors of
high blood pressure and high cholesterol signs
and symptoms of heart attack and stroke and the
need to call 9-1-1 are also components of capacity
enhancement
An overarching goal of the State HDSP Program
is to address disparities in heart disease and
stroke and the related risk factors using policy and
systems change strategies Based on disparities
(eg raceethnicity gender geographic geography
socioeconomic status) in mortality access to care
or burden of risk factors the State HDSP Program
should identify Priority Populations and implement
interventions to reach those Priority Populations
No one organization will be able to address the
prevention of heart disease and stroke It will require
many organizations working in collaboration if
progress is to be made in accomplishing the Healthy
People 2010 Objectives Collaboration is defined
by the Wilder Foundation as ldquoa mutually beneficial
and well-defined relationship entered into by two
or more organizations to achieve common goals
The relationship includes a commitment to mutual
relationships and goals a jointly developed structure
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20
and shared responsibility mutual authority and
accountability for success and sharing of resources
and rewardsrdquo Developing and maintaining
strategic partnerships are key to the leveraging of
skills and resources to prevent heart disease and
stroke in a comprehensive way The State HDSP
Program has two major roles related to partners
The first is to convene or facilitate collaboration
to develop and implement a comprehensive state
plan and intervention implementation strategies
that addresses heart disease stroke and related
risk factors The second is to develop strategies to
leverage resources and coordinate interventions
with partners that address the six program
priority areas
A logic model has been developed to describe
the State HDSP Program as intended by the CDC
funding to state health departments (see following
page) The model depicts relationships and actions
(eg links between environment and policy
change and individual-level behavioral change)
that are expected to culminate in reduction in
heart disease and stroke
The CDC and state activities are outlined in terms
of capacity building surveillancemonitoring
and interventions Both CDC and state activities
influence changes that lead to short-term
outcomes such as development of a work plan
and strategies for system-level changes effective
implementation of interventions and action by
target audiences and change agents (those who are
in the position to influence policies and systems
such as hospital administrators and MCO decision
makers) These activities and outcomes result in
changes in policy and environmental supports
which in turn influence behavior changes and
improve health status Ultimately these changes
decrease premature death and disability and
eliminate cardiovascular disparities between
general and Priority Populations
The State HDSP logic model also is a tool to guide
program evaluation By identifying the steps
necessary to reach intended outcomes the logic
model provides guidance in evaluating the short and
intermediate outcomes of the program
State evaluation efforts should relate to the National
HDSP Program logic model or to a logic model that
the state develops that complements the national
model and the required program recipient activities
The logic model can also be seen in the CDC
Evaluation Framework for Heart Disease and Stroke
Prevention State Programs at wwwcdcgovdhdsp
Section 2 National Heart Disease and Stroke Prevention State Program Roles In A Public Health Action Plan to Prevent Heart
Disease and Stroke there are four major goals which
are based on Healthy People 2010
Goal 1 Prevention of risk factors
Goal 2 Detection and treatment of risk factors
Goal 3 Early identification and treatment of heart
attacks and strokes
Goal 4 Prevention of recurrent cardiovascular events
CDC-funded State HDSP Programs have a direct
impact on Goals 2 3 and 4 by addressing HDSP
program priority areas 1ndash6 (see Background section)
HDSP programs have a supportive role with other
state health department programs and partners in
addressing Goal 1 Efforts to address Goal 1 related
to tobacco use diabetes obesity poor nutrition
physical inactivity and schools as a worksite should
be done through a supportive or collaborative role
with the state WISEWOMAN diabetes tobacco
nutrition physical activity or coordinated school
health programs
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bull State HDSP Programs are encouraged to
coordinate with other programs in ways that
1 Address Goal 1 (eg State HDSP and Nutrition
Programs identify primary prevention messages
related to cholesterol and salt to be included in Nushy
trition Programs where appropriate State HDSP and
Tobacco Programs collaborate to promote use of
state tobacco quit lines State HDSP Program refers
managed care organizations to materials developed
by the Parks and Recreation Department and
Physical Activity Program on safe places to exercise
National HDSP Program Logic Model
State HDSP and WISEWOMAN Programs collaborate
to create systems for educating health care providers
on guidelines focused on risk factor prevention)
2 Enhance inclusion of key messages in the work
of related programs (eg State HDSP Program
works to implement JNC7 guidelines which
include referral to nutrition counseling the
WISEWOMAN Program incorporates education on
signs and symptoms of heart disease and stroke
into ongoing activities the State HDSP Program
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and system change supports
Level bull State bull Local
Settings bull Community bull Health care bull Worksite
Context bull Priority
Populations bull General
populations
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective intervention
implemented focused on
settings and Priority Populations
Change agents
take action
Activate intended audiences
Capa
city B
uildin
gSu
rveil
lance
Inter
vent
ions
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
21
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encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
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23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
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25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
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26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
13
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
National Heart Disease and Stroke Prevention Program Overview
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
14
u Blood pressure Prevent and control high blood Program Overview pressure reduce sodium intake
bull In 1998 the US Congress provided funding
for CDC to initiate a national state-based Heart
Disease and Stroke Prevention (HDSP) program in
eight states
bull CDC funds programs in 41 states and the
District of Columbia Twenty-eight are capacity
building (planning) programs and 14 are basic
implementation (intervention) programs
bull Capacity Building Programs Alabama
Alaska Arizona California Colorado Connecticut
District of Columbia Hawaii Idaho Illinois Iowa
Kansas Kentucky Louisiana Maryland Michigan
Minnesota Mississippi Nebraska New Jersey
North Dakota Ohio Oklahoma Oregon Rhode
Island Tennessee Texas and Wisconsin
bull Basic Implementation Programs Arkansas
Florida Georgia Maine Massachusetts Missouri
Montana New York North Carolina South
Carolina Utah Virginia Washington and West
Virginia
National Heart Disease and Stroke Prevention Program Goals bull Enhance state capacity to plan implement track
and sustain population-based interventions to
address heart disease stroke and related risk
factors Focus program efforts on population-
based policy and systems change strategies to
impact the ldquoABCSrdquo of heart disease and stroke
prevention
u Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
u Cholesterol Prevent and control high
cholesterol
u Smoking Increase the number of smokers
counseled to quit and referred to quitlines by
health care workers increase availability of no
or low-cost cessation products and collaborate
with efforts to increase the percentage of the
population protected by smoke-free air laws
and regulations
To a lesser extent state HDSP programs work to
improve emergency response and quality of acute
care systems
State HDSP programs work to eliminate health
disparities in priority populations (ie groups with
increased burden or need based on race ethnicity
gender geography or socioeconomic status) as an
overarching principle
bull Collaborate with chronic disease programs (eg
those focusing on tobacco diabetes physical
inactivity poor nutrition and obesityoverweight)
and partners to develop and integrate population-
based strategies to prevent heart disease and
stroke
bull Promote cardiovascular health in health care
worksite and community settings through policy
and systems changes
bull Identify and evaluate promising practices to
address heart disease and stroke
bull Conduct surveillance of heart disease stroke
and related risk factors
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
15
u
u
Key Responsibilities of State Capacity Building Programs bull Facilitate collaboration with public- and private-
sector partners such as not-for-profit health
agencies health systems organizations emergency
response agencies federally funded health centers
businesses priority population organizations and
voluntary health organizations
bull Document the state burden of heart disease
stroke and related risk factors
bull Develop plans for population-based strategies
for preventing heart disease and stroke among
general and Priority Populations
bull Develop a comprehensive state HDSP plan
bull Develop an HDSP program logic model and
evaluation plan
bull Assess assets and gaps in state policy and systems
related to HDSP in health care worksite and
community settings
Key Responsibilities of State Basic Implementation Programs bull Enhance all capacity-building program activities
bull Implement and evaluate policy systems change
and educational interventions that address the
six HDSP program priority areas in health care
worksite and community settings
bull Provide training and technical assistance to
public health and health care professionals and
partners to support policy and system changes
that will encourage heart disease and stroke
prevention
How CDC Assists State Heart Disease and Stroke Prevention Programs bull Provides training technical assistance and
funding
bull Funds applied research on heart disease and
stroke interventions and elimination of disparities
that is relevant to state programs
bull Identifies and disseminates science-based
promising practices
bull Partners with national organizations to help states
address prevention of heart disease and stroke
bull Facilitates collaborations with other state chronic
disease programs or activities that address risk
factors populations or settings related to heart
disease and stroke prevention and program
priority areas
bull Develops and disseminates publications and tools
such as
u CDCynergy a CD-ROM-based tool for
planning health communication interventions
State Heart Disease and Stroke Prevention
Program Evaluation Framework (wwwcdc
govdhdsplibraryevaluation_framework
indexhtm) a document providing guidance
on systematic ways to measure the success of
public health programs and on logic model
development
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping an
Evaluation Plan (wwwcdcgovDHDSPstate_
programevaluation_guidesevaluation_plan
htm) a document providing guidance on the
development of evaluation activities to help
programs identify required staff time and
resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
16
u
u
u
u
u
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping and
Using a Logic Model (wwwcdcgovDHDSP
state_programevaluation_guideslogic_model
htm) a document providing guidance on
the development and use of logic models as
planning and evaluation tools
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashWriting SMART
Objectives (wwwcdcgovDHDSPstate_
programevaluation_guidessmart_objectives
htm) a document providing guidance to
states on the development of realistic and
measurable objectives
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit (wwwcdcgov
dhdsplibrarytoolkitindexhtm) a document
that provides information materials and
tools that state programs can reference and
distribute to businesses primarily through
employer and professional organizations
Heart Disease and Stroke Interactive Maps
(wwwcdcgovdhdsplibrarymapsstatemaps
htm) which present heart disease and stroke
mortality rates by county for the state racial
ethnic group and gender of the userrsquos choice
A Communication Guide for Policy and
Environmental Change (wwwcdcgovdhdsp
libraryheart_stroke_guideindexhtm) which
includes information references and examples
of communication from state programs and
Stroke Addendum to the Communication
Guide (wwwcdcgovdhdsplibraryheart_
stroke_guideindexhtm)
For additional information please visit the CDC
website at wwwcdcgovdhdsp or contact the
Division for Heart Disease and Stroke Prevention
Program Development and Services Branch at
(770) 488-2424
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
17
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
State Heart Disease and Stroke Prevention Program Funding Opportunity Announcement DP07-704 At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
18
Introduction The Funding Opportunity Announcement
(FOA) DP07-704 At-A-Glance provides important
information to assist programs funded under this
announcement to deliver their program as intended
The At-A-Glance highlights aspects of FOA DP07-704
important for all funded programs including
the following
bull Overview of the National Heart Disease and
Stroke Prevention Program
bull Heart Disease and Stroke Prevention State
Program roles
bull Performance measures for Capacity Building Basic
Implementation Optional Funding for Capacity
Building programs and Stroke Networks
bull Funded program reporting requirements
bull Budgetfunding guidance
bull National and administrative policy requirements
If a program needs a copy of the full document
it should contact its project officer (see Program
Contacts section of the full National Heart Disease
and Stroke Prevention Program Staff Orientation
Manual) to fulfill that request
Section 1 Background In 1998 the US Congress provided funding for
CDC to initiate a national state-based cardiovascular
health program The Senate Appropriations
Committee in 2005 encouraged CDC to create the
Division for Heart Disease and Stroke Prevention and
increased resources enabling CDC to reach 32 of the
50 states and the District of Columbia with funding
for heart disease and stroke prevention As of 2008
the Heart Disease and Stroke Prevention (HDSP)
program funds 41 states and the District of Columbia
As the Division for Heart Disease and Stroke
Prevention developed so did the focus of the State
HDSP Program Focusing on the six program priority
areas (noted below) should impact morbidity and
mortality of these diseases State programs should
increase heart disease and stroke prevention policies
and systems change with the potential to impact
the general population and Priority Populations
(see Prevention Works CDC Strategies for a Heart-
healthy and Stroke-free America wwwCDCgov
dhdsplibrary) For more information on the CDC
State HDSP Program visit wwwcdcgovdhdspState_
programindexhtm
A Public Health Action Plan to Prevent Heart Disease
and Stroke (see wwwCDCgovdhdsplibrary)
documents the multiple intervention opportunities
for preventing heart disease and stroke It is
important to work with partners collaboratively in
leveraging resources to address the multiple risk
factors that are associated with these diseases
Announcement DP07-704 supports program
components considered essential to enhancing
the leadership of state health departments in
heart disease and stroke prevention It provides
for the funding of capacity building and basic
implementation programs as well as projects such as
the Optional Funding for Capacity Building Programs
and Stroke Networks
A capacity building program develops the foundation
for a comprehensive cardiovascular disease prevention
program through such activities as partnership
development definition of the burden and
development of a state plan A basic implementation
program enhances capacity building activities and
implements disseminates and evaluates intervention
activities that address the state plan objectives and the
CDC program priority areas 1ndash6
1 Increase control of high blood pressure primarily
in adults and older adults
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19
2 Increase control of high blood cholesterol
primarily in adults and older adults
3 Increase knowledge of signs and symptoms for
heart attack and stroke and the importance of
calling 9-1-1
4 Improve emergency response
5 Improve quality of heart disease and stroke care
6 Eliminate disparities in terms of race ethnicity
gender geography or socioeconomic status
Optional Funding for Capacity Building Programs
provides support to programs to implement an
evidence-based or promising practice demonstration
project that addresses the CDC program priority
areas 1ndash6
Stroke Networks support a state health department to
increase stroke prevention activities across a group of
three to six contiguous member states with emphasis
on increasing awareness and implementing priority
policy or systems changes across the states
The State HDSP Program is anchored on the
framework of the Socio-ecological Model which
conceptualized the influences of individual
behaviors family and social relationships community
and environmental effects and societal influences
such as policies on health status In order to
promote significant impact for improving the health
of the population interventions should focus on
implementing policy and systems change strategies
that support heart disease and stroke prevention
Policy change can be addressed through a) public
policy (eg establishing certification for hospital-
based stroke centers) or b) organizational policy
(eg businesses providing health benefits plans
that cover preventive services that include blood
pressure control)
System changes are encouraged in three settings
worksites health care and communities An
example of a systems change is when a health
care setting implements electronic records and
patient care management systems that improve the
quality of health care Interventions within systems
are encouraged at the highest level possiblemdashfor
example activities with business coalitions rather
than individual worksites and with managed care
organizations (MCOs) and state medical associations
rather than individual health care sites or physicians
By working at higher levels to affect systems change
states can impact larger segments of the population
Education and awareness efforts to enhance
public understanding and promote actions related
to cardiovascular diseases and the risk factors of
high blood pressure and high cholesterol signs
and symptoms of heart attack and stroke and the
need to call 9-1-1 are also components of capacity
enhancement
An overarching goal of the State HDSP Program
is to address disparities in heart disease and
stroke and the related risk factors using policy and
systems change strategies Based on disparities
(eg raceethnicity gender geographic geography
socioeconomic status) in mortality access to care
or burden of risk factors the State HDSP Program
should identify Priority Populations and implement
interventions to reach those Priority Populations
No one organization will be able to address the
prevention of heart disease and stroke It will require
many organizations working in collaboration if
progress is to be made in accomplishing the Healthy
People 2010 Objectives Collaboration is defined
by the Wilder Foundation as ldquoa mutually beneficial
and well-defined relationship entered into by two
or more organizations to achieve common goals
The relationship includes a commitment to mutual
relationships and goals a jointly developed structure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
20
and shared responsibility mutual authority and
accountability for success and sharing of resources
and rewardsrdquo Developing and maintaining
strategic partnerships are key to the leveraging of
skills and resources to prevent heart disease and
stroke in a comprehensive way The State HDSP
Program has two major roles related to partners
The first is to convene or facilitate collaboration
to develop and implement a comprehensive state
plan and intervention implementation strategies
that addresses heart disease stroke and related
risk factors The second is to develop strategies to
leverage resources and coordinate interventions
with partners that address the six program
priority areas
A logic model has been developed to describe
the State HDSP Program as intended by the CDC
funding to state health departments (see following
page) The model depicts relationships and actions
(eg links between environment and policy
change and individual-level behavioral change)
that are expected to culminate in reduction in
heart disease and stroke
The CDC and state activities are outlined in terms
of capacity building surveillancemonitoring
and interventions Both CDC and state activities
influence changes that lead to short-term
outcomes such as development of a work plan
and strategies for system-level changes effective
implementation of interventions and action by
target audiences and change agents (those who are
in the position to influence policies and systems
such as hospital administrators and MCO decision
makers) These activities and outcomes result in
changes in policy and environmental supports
which in turn influence behavior changes and
improve health status Ultimately these changes
decrease premature death and disability and
eliminate cardiovascular disparities between
general and Priority Populations
The State HDSP logic model also is a tool to guide
program evaluation By identifying the steps
necessary to reach intended outcomes the logic
model provides guidance in evaluating the short and
intermediate outcomes of the program
State evaluation efforts should relate to the National
HDSP Program logic model or to a logic model that
the state develops that complements the national
model and the required program recipient activities
The logic model can also be seen in the CDC
Evaluation Framework for Heart Disease and Stroke
Prevention State Programs at wwwcdcgovdhdsp
Section 2 National Heart Disease and Stroke Prevention State Program Roles In A Public Health Action Plan to Prevent Heart
Disease and Stroke there are four major goals which
are based on Healthy People 2010
Goal 1 Prevention of risk factors
Goal 2 Detection and treatment of risk factors
Goal 3 Early identification and treatment of heart
attacks and strokes
Goal 4 Prevention of recurrent cardiovascular events
CDC-funded State HDSP Programs have a direct
impact on Goals 2 3 and 4 by addressing HDSP
program priority areas 1ndash6 (see Background section)
HDSP programs have a supportive role with other
state health department programs and partners in
addressing Goal 1 Efforts to address Goal 1 related
to tobacco use diabetes obesity poor nutrition
physical inactivity and schools as a worksite should
be done through a supportive or collaborative role
with the state WISEWOMAN diabetes tobacco
nutrition physical activity or coordinated school
health programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
bull State HDSP Programs are encouraged to
coordinate with other programs in ways that
1 Address Goal 1 (eg State HDSP and Nutrition
Programs identify primary prevention messages
related to cholesterol and salt to be included in Nushy
trition Programs where appropriate State HDSP and
Tobacco Programs collaborate to promote use of
state tobacco quit lines State HDSP Program refers
managed care organizations to materials developed
by the Parks and Recreation Department and
Physical Activity Program on safe places to exercise
National HDSP Program Logic Model
State HDSP and WISEWOMAN Programs collaborate
to create systems for educating health care providers
on guidelines focused on risk factor prevention)
2 Enhance inclusion of key messages in the work
of related programs (eg State HDSP Program
works to implement JNC7 guidelines which
include referral to nutrition counseling the
WISEWOMAN Program incorporates education on
signs and symptoms of heart disease and stroke
into ongoing activities the State HDSP Program
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and system change supports
Level bull State bull Local
Settings bull Community bull Health care bull Worksite
Context bull Priority
Populations bull General
populations
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective intervention
implemented focused on
settings and Priority Populations
Change agents
take action
Activate intended audiences
Capa
city B
uildin
gSu
rveil
lance
Inter
vent
ions
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
21
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
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25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
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26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
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53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
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55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
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14
u Blood pressure Prevent and control high blood Program Overview pressure reduce sodium intake
bull In 1998 the US Congress provided funding
for CDC to initiate a national state-based Heart
Disease and Stroke Prevention (HDSP) program in
eight states
bull CDC funds programs in 41 states and the
District of Columbia Twenty-eight are capacity
building (planning) programs and 14 are basic
implementation (intervention) programs
bull Capacity Building Programs Alabama
Alaska Arizona California Colorado Connecticut
District of Columbia Hawaii Idaho Illinois Iowa
Kansas Kentucky Louisiana Maryland Michigan
Minnesota Mississippi Nebraska New Jersey
North Dakota Ohio Oklahoma Oregon Rhode
Island Tennessee Texas and Wisconsin
bull Basic Implementation Programs Arkansas
Florida Georgia Maine Massachusetts Missouri
Montana New York North Carolina South
Carolina Utah Virginia Washington and West
Virginia
National Heart Disease and Stroke Prevention Program Goals bull Enhance state capacity to plan implement track
and sustain population-based interventions to
address heart disease stroke and related risk
factors Focus program efforts on population-
based policy and systems change strategies to
impact the ldquoABCSrdquo of heart disease and stroke
prevention
u Aspirin Increase low-dose aspirin therapy
according to recognized guidelines
u Cholesterol Prevent and control high
cholesterol
u Smoking Increase the number of smokers
counseled to quit and referred to quitlines by
health care workers increase availability of no
or low-cost cessation products and collaborate
with efforts to increase the percentage of the
population protected by smoke-free air laws
and regulations
To a lesser extent state HDSP programs work to
improve emergency response and quality of acute
care systems
State HDSP programs work to eliminate health
disparities in priority populations (ie groups with
increased burden or need based on race ethnicity
gender geography or socioeconomic status) as an
overarching principle
bull Collaborate with chronic disease programs (eg
those focusing on tobacco diabetes physical
inactivity poor nutrition and obesityoverweight)
and partners to develop and integrate population-
based strategies to prevent heart disease and
stroke
bull Promote cardiovascular health in health care
worksite and community settings through policy
and systems changes
bull Identify and evaluate promising practices to
address heart disease and stroke
bull Conduct surveillance of heart disease stroke
and related risk factors
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15
u
u
Key Responsibilities of State Capacity Building Programs bull Facilitate collaboration with public- and private-
sector partners such as not-for-profit health
agencies health systems organizations emergency
response agencies federally funded health centers
businesses priority population organizations and
voluntary health organizations
bull Document the state burden of heart disease
stroke and related risk factors
bull Develop plans for population-based strategies
for preventing heart disease and stroke among
general and Priority Populations
bull Develop a comprehensive state HDSP plan
bull Develop an HDSP program logic model and
evaluation plan
bull Assess assets and gaps in state policy and systems
related to HDSP in health care worksite and
community settings
Key Responsibilities of State Basic Implementation Programs bull Enhance all capacity-building program activities
bull Implement and evaluate policy systems change
and educational interventions that address the
six HDSP program priority areas in health care
worksite and community settings
bull Provide training and technical assistance to
public health and health care professionals and
partners to support policy and system changes
that will encourage heart disease and stroke
prevention
How CDC Assists State Heart Disease and Stroke Prevention Programs bull Provides training technical assistance and
funding
bull Funds applied research on heart disease and
stroke interventions and elimination of disparities
that is relevant to state programs
bull Identifies and disseminates science-based
promising practices
bull Partners with national organizations to help states
address prevention of heart disease and stroke
bull Facilitates collaborations with other state chronic
disease programs or activities that address risk
factors populations or settings related to heart
disease and stroke prevention and program
priority areas
bull Develops and disseminates publications and tools
such as
u CDCynergy a CD-ROM-based tool for
planning health communication interventions
State Heart Disease and Stroke Prevention
Program Evaluation Framework (wwwcdc
govdhdsplibraryevaluation_framework
indexhtm) a document providing guidance
on systematic ways to measure the success of
public health programs and on logic model
development
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping an
Evaluation Plan (wwwcdcgovDHDSPstate_
programevaluation_guidesevaluation_plan
htm) a document providing guidance on the
development of evaluation activities to help
programs identify required staff time and
resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
16
u
u
u
u
u
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping and
Using a Logic Model (wwwcdcgovDHDSP
state_programevaluation_guideslogic_model
htm) a document providing guidance on
the development and use of logic models as
planning and evaluation tools
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashWriting SMART
Objectives (wwwcdcgovDHDSPstate_
programevaluation_guidessmart_objectives
htm) a document providing guidance to
states on the development of realistic and
measurable objectives
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit (wwwcdcgov
dhdsplibrarytoolkitindexhtm) a document
that provides information materials and
tools that state programs can reference and
distribute to businesses primarily through
employer and professional organizations
Heart Disease and Stroke Interactive Maps
(wwwcdcgovdhdsplibrarymapsstatemaps
htm) which present heart disease and stroke
mortality rates by county for the state racial
ethnic group and gender of the userrsquos choice
A Communication Guide for Policy and
Environmental Change (wwwcdcgovdhdsp
libraryheart_stroke_guideindexhtm) which
includes information references and examples
of communication from state programs and
Stroke Addendum to the Communication
Guide (wwwcdcgovdhdsplibraryheart_
stroke_guideindexhtm)
For additional information please visit the CDC
website at wwwcdcgovdhdsp or contact the
Division for Heart Disease and Stroke Prevention
Program Development and Services Branch at
(770) 488-2424
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
17
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
State Heart Disease and Stroke Prevention Program Funding Opportunity Announcement DP07-704 At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
18
Introduction The Funding Opportunity Announcement
(FOA) DP07-704 At-A-Glance provides important
information to assist programs funded under this
announcement to deliver their program as intended
The At-A-Glance highlights aspects of FOA DP07-704
important for all funded programs including
the following
bull Overview of the National Heart Disease and
Stroke Prevention Program
bull Heart Disease and Stroke Prevention State
Program roles
bull Performance measures for Capacity Building Basic
Implementation Optional Funding for Capacity
Building programs and Stroke Networks
bull Funded program reporting requirements
bull Budgetfunding guidance
bull National and administrative policy requirements
If a program needs a copy of the full document
it should contact its project officer (see Program
Contacts section of the full National Heart Disease
and Stroke Prevention Program Staff Orientation
Manual) to fulfill that request
Section 1 Background In 1998 the US Congress provided funding for
CDC to initiate a national state-based cardiovascular
health program The Senate Appropriations
Committee in 2005 encouraged CDC to create the
Division for Heart Disease and Stroke Prevention and
increased resources enabling CDC to reach 32 of the
50 states and the District of Columbia with funding
for heart disease and stroke prevention As of 2008
the Heart Disease and Stroke Prevention (HDSP)
program funds 41 states and the District of Columbia
As the Division for Heart Disease and Stroke
Prevention developed so did the focus of the State
HDSP Program Focusing on the six program priority
areas (noted below) should impact morbidity and
mortality of these diseases State programs should
increase heart disease and stroke prevention policies
and systems change with the potential to impact
the general population and Priority Populations
(see Prevention Works CDC Strategies for a Heart-
healthy and Stroke-free America wwwCDCgov
dhdsplibrary) For more information on the CDC
State HDSP Program visit wwwcdcgovdhdspState_
programindexhtm
A Public Health Action Plan to Prevent Heart Disease
and Stroke (see wwwCDCgovdhdsplibrary)
documents the multiple intervention opportunities
for preventing heart disease and stroke It is
important to work with partners collaboratively in
leveraging resources to address the multiple risk
factors that are associated with these diseases
Announcement DP07-704 supports program
components considered essential to enhancing
the leadership of state health departments in
heart disease and stroke prevention It provides
for the funding of capacity building and basic
implementation programs as well as projects such as
the Optional Funding for Capacity Building Programs
and Stroke Networks
A capacity building program develops the foundation
for a comprehensive cardiovascular disease prevention
program through such activities as partnership
development definition of the burden and
development of a state plan A basic implementation
program enhances capacity building activities and
implements disseminates and evaluates intervention
activities that address the state plan objectives and the
CDC program priority areas 1ndash6
1 Increase control of high blood pressure primarily
in adults and older adults
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
19
2 Increase control of high blood cholesterol
primarily in adults and older adults
3 Increase knowledge of signs and symptoms for
heart attack and stroke and the importance of
calling 9-1-1
4 Improve emergency response
5 Improve quality of heart disease and stroke care
6 Eliminate disparities in terms of race ethnicity
gender geography or socioeconomic status
Optional Funding for Capacity Building Programs
provides support to programs to implement an
evidence-based or promising practice demonstration
project that addresses the CDC program priority
areas 1ndash6
Stroke Networks support a state health department to
increase stroke prevention activities across a group of
three to six contiguous member states with emphasis
on increasing awareness and implementing priority
policy or systems changes across the states
The State HDSP Program is anchored on the
framework of the Socio-ecological Model which
conceptualized the influences of individual
behaviors family and social relationships community
and environmental effects and societal influences
such as policies on health status In order to
promote significant impact for improving the health
of the population interventions should focus on
implementing policy and systems change strategies
that support heart disease and stroke prevention
Policy change can be addressed through a) public
policy (eg establishing certification for hospital-
based stroke centers) or b) organizational policy
(eg businesses providing health benefits plans
that cover preventive services that include blood
pressure control)
System changes are encouraged in three settings
worksites health care and communities An
example of a systems change is when a health
care setting implements electronic records and
patient care management systems that improve the
quality of health care Interventions within systems
are encouraged at the highest level possiblemdashfor
example activities with business coalitions rather
than individual worksites and with managed care
organizations (MCOs) and state medical associations
rather than individual health care sites or physicians
By working at higher levels to affect systems change
states can impact larger segments of the population
Education and awareness efforts to enhance
public understanding and promote actions related
to cardiovascular diseases and the risk factors of
high blood pressure and high cholesterol signs
and symptoms of heart attack and stroke and the
need to call 9-1-1 are also components of capacity
enhancement
An overarching goal of the State HDSP Program
is to address disparities in heart disease and
stroke and the related risk factors using policy and
systems change strategies Based on disparities
(eg raceethnicity gender geographic geography
socioeconomic status) in mortality access to care
or burden of risk factors the State HDSP Program
should identify Priority Populations and implement
interventions to reach those Priority Populations
No one organization will be able to address the
prevention of heart disease and stroke It will require
many organizations working in collaboration if
progress is to be made in accomplishing the Healthy
People 2010 Objectives Collaboration is defined
by the Wilder Foundation as ldquoa mutually beneficial
and well-defined relationship entered into by two
or more organizations to achieve common goals
The relationship includes a commitment to mutual
relationships and goals a jointly developed structure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
20
and shared responsibility mutual authority and
accountability for success and sharing of resources
and rewardsrdquo Developing and maintaining
strategic partnerships are key to the leveraging of
skills and resources to prevent heart disease and
stroke in a comprehensive way The State HDSP
Program has two major roles related to partners
The first is to convene or facilitate collaboration
to develop and implement a comprehensive state
plan and intervention implementation strategies
that addresses heart disease stroke and related
risk factors The second is to develop strategies to
leverage resources and coordinate interventions
with partners that address the six program
priority areas
A logic model has been developed to describe
the State HDSP Program as intended by the CDC
funding to state health departments (see following
page) The model depicts relationships and actions
(eg links between environment and policy
change and individual-level behavioral change)
that are expected to culminate in reduction in
heart disease and stroke
The CDC and state activities are outlined in terms
of capacity building surveillancemonitoring
and interventions Both CDC and state activities
influence changes that lead to short-term
outcomes such as development of a work plan
and strategies for system-level changes effective
implementation of interventions and action by
target audiences and change agents (those who are
in the position to influence policies and systems
such as hospital administrators and MCO decision
makers) These activities and outcomes result in
changes in policy and environmental supports
which in turn influence behavior changes and
improve health status Ultimately these changes
decrease premature death and disability and
eliminate cardiovascular disparities between
general and Priority Populations
The State HDSP logic model also is a tool to guide
program evaluation By identifying the steps
necessary to reach intended outcomes the logic
model provides guidance in evaluating the short and
intermediate outcomes of the program
State evaluation efforts should relate to the National
HDSP Program logic model or to a logic model that
the state develops that complements the national
model and the required program recipient activities
The logic model can also be seen in the CDC
Evaluation Framework for Heart Disease and Stroke
Prevention State Programs at wwwcdcgovdhdsp
Section 2 National Heart Disease and Stroke Prevention State Program Roles In A Public Health Action Plan to Prevent Heart
Disease and Stroke there are four major goals which
are based on Healthy People 2010
Goal 1 Prevention of risk factors
Goal 2 Detection and treatment of risk factors
Goal 3 Early identification and treatment of heart
attacks and strokes
Goal 4 Prevention of recurrent cardiovascular events
CDC-funded State HDSP Programs have a direct
impact on Goals 2 3 and 4 by addressing HDSP
program priority areas 1ndash6 (see Background section)
HDSP programs have a supportive role with other
state health department programs and partners in
addressing Goal 1 Efforts to address Goal 1 related
to tobacco use diabetes obesity poor nutrition
physical inactivity and schools as a worksite should
be done through a supportive or collaborative role
with the state WISEWOMAN diabetes tobacco
nutrition physical activity or coordinated school
health programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
bull State HDSP Programs are encouraged to
coordinate with other programs in ways that
1 Address Goal 1 (eg State HDSP and Nutrition
Programs identify primary prevention messages
related to cholesterol and salt to be included in Nushy
trition Programs where appropriate State HDSP and
Tobacco Programs collaborate to promote use of
state tobacco quit lines State HDSP Program refers
managed care organizations to materials developed
by the Parks and Recreation Department and
Physical Activity Program on safe places to exercise
National HDSP Program Logic Model
State HDSP and WISEWOMAN Programs collaborate
to create systems for educating health care providers
on guidelines focused on risk factor prevention)
2 Enhance inclusion of key messages in the work
of related programs (eg State HDSP Program
works to implement JNC7 guidelines which
include referral to nutrition counseling the
WISEWOMAN Program incorporates education on
signs and symptoms of heart disease and stroke
into ongoing activities the State HDSP Program
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and system change supports
Level bull State bull Local
Settings bull Community bull Health care bull Worksite
Context bull Priority
Populations bull General
populations
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective intervention
implemented focused on
settings and Priority Populations
Change agents
take action
Activate intended audiences
Capa
city B
uildin
gSu
rveil
lance
Inter
vent
ions
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
21
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
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55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
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15
u
u
Key Responsibilities of State Capacity Building Programs bull Facilitate collaboration with public- and private-
sector partners such as not-for-profit health
agencies health systems organizations emergency
response agencies federally funded health centers
businesses priority population organizations and
voluntary health organizations
bull Document the state burden of heart disease
stroke and related risk factors
bull Develop plans for population-based strategies
for preventing heart disease and stroke among
general and Priority Populations
bull Develop a comprehensive state HDSP plan
bull Develop an HDSP program logic model and
evaluation plan
bull Assess assets and gaps in state policy and systems
related to HDSP in health care worksite and
community settings
Key Responsibilities of State Basic Implementation Programs bull Enhance all capacity-building program activities
bull Implement and evaluate policy systems change
and educational interventions that address the
six HDSP program priority areas in health care
worksite and community settings
bull Provide training and technical assistance to
public health and health care professionals and
partners to support policy and system changes
that will encourage heart disease and stroke
prevention
How CDC Assists State Heart Disease and Stroke Prevention Programs bull Provides training technical assistance and
funding
bull Funds applied research on heart disease and
stroke interventions and elimination of disparities
that is relevant to state programs
bull Identifies and disseminates science-based
promising practices
bull Partners with national organizations to help states
address prevention of heart disease and stroke
bull Facilitates collaborations with other state chronic
disease programs or activities that address risk
factors populations or settings related to heart
disease and stroke prevention and program
priority areas
bull Develops and disseminates publications and tools
such as
u CDCynergy a CD-ROM-based tool for
planning health communication interventions
State Heart Disease and Stroke Prevention
Program Evaluation Framework (wwwcdc
govdhdsplibraryevaluation_framework
indexhtm) a document providing guidance
on systematic ways to measure the success of
public health programs and on logic model
development
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping an
Evaluation Plan (wwwcdcgovDHDSPstate_
programevaluation_guidesevaluation_plan
htm) a document providing guidance on the
development of evaluation activities to help
programs identify required staff time and
resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
16
u
u
u
u
u
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping and
Using a Logic Model (wwwcdcgovDHDSP
state_programevaluation_guideslogic_model
htm) a document providing guidance on
the development and use of logic models as
planning and evaluation tools
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashWriting SMART
Objectives (wwwcdcgovDHDSPstate_
programevaluation_guidessmart_objectives
htm) a document providing guidance to
states on the development of realistic and
measurable objectives
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit (wwwcdcgov
dhdsplibrarytoolkitindexhtm) a document
that provides information materials and
tools that state programs can reference and
distribute to businesses primarily through
employer and professional organizations
Heart Disease and Stroke Interactive Maps
(wwwcdcgovdhdsplibrarymapsstatemaps
htm) which present heart disease and stroke
mortality rates by county for the state racial
ethnic group and gender of the userrsquos choice
A Communication Guide for Policy and
Environmental Change (wwwcdcgovdhdsp
libraryheart_stroke_guideindexhtm) which
includes information references and examples
of communication from state programs and
Stroke Addendum to the Communication
Guide (wwwcdcgovdhdsplibraryheart_
stroke_guideindexhtm)
For additional information please visit the CDC
website at wwwcdcgovdhdsp or contact the
Division for Heart Disease and Stroke Prevention
Program Development and Services Branch at
(770) 488-2424
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17
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
State Heart Disease and Stroke Prevention Program Funding Opportunity Announcement DP07-704 At-A-Glance
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18
Introduction The Funding Opportunity Announcement
(FOA) DP07-704 At-A-Glance provides important
information to assist programs funded under this
announcement to deliver their program as intended
The At-A-Glance highlights aspects of FOA DP07-704
important for all funded programs including
the following
bull Overview of the National Heart Disease and
Stroke Prevention Program
bull Heart Disease and Stroke Prevention State
Program roles
bull Performance measures for Capacity Building Basic
Implementation Optional Funding for Capacity
Building programs and Stroke Networks
bull Funded program reporting requirements
bull Budgetfunding guidance
bull National and administrative policy requirements
If a program needs a copy of the full document
it should contact its project officer (see Program
Contacts section of the full National Heart Disease
and Stroke Prevention Program Staff Orientation
Manual) to fulfill that request
Section 1 Background In 1998 the US Congress provided funding for
CDC to initiate a national state-based cardiovascular
health program The Senate Appropriations
Committee in 2005 encouraged CDC to create the
Division for Heart Disease and Stroke Prevention and
increased resources enabling CDC to reach 32 of the
50 states and the District of Columbia with funding
for heart disease and stroke prevention As of 2008
the Heart Disease and Stroke Prevention (HDSP)
program funds 41 states and the District of Columbia
As the Division for Heart Disease and Stroke
Prevention developed so did the focus of the State
HDSP Program Focusing on the six program priority
areas (noted below) should impact morbidity and
mortality of these diseases State programs should
increase heart disease and stroke prevention policies
and systems change with the potential to impact
the general population and Priority Populations
(see Prevention Works CDC Strategies for a Heart-
healthy and Stroke-free America wwwCDCgov
dhdsplibrary) For more information on the CDC
State HDSP Program visit wwwcdcgovdhdspState_
programindexhtm
A Public Health Action Plan to Prevent Heart Disease
and Stroke (see wwwCDCgovdhdsplibrary)
documents the multiple intervention opportunities
for preventing heart disease and stroke It is
important to work with partners collaboratively in
leveraging resources to address the multiple risk
factors that are associated with these diseases
Announcement DP07-704 supports program
components considered essential to enhancing
the leadership of state health departments in
heart disease and stroke prevention It provides
for the funding of capacity building and basic
implementation programs as well as projects such as
the Optional Funding for Capacity Building Programs
and Stroke Networks
A capacity building program develops the foundation
for a comprehensive cardiovascular disease prevention
program through such activities as partnership
development definition of the burden and
development of a state plan A basic implementation
program enhances capacity building activities and
implements disseminates and evaluates intervention
activities that address the state plan objectives and the
CDC program priority areas 1ndash6
1 Increase control of high blood pressure primarily
in adults and older adults
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19
2 Increase control of high blood cholesterol
primarily in adults and older adults
3 Increase knowledge of signs and symptoms for
heart attack and stroke and the importance of
calling 9-1-1
4 Improve emergency response
5 Improve quality of heart disease and stroke care
6 Eliminate disparities in terms of race ethnicity
gender geography or socioeconomic status
Optional Funding for Capacity Building Programs
provides support to programs to implement an
evidence-based or promising practice demonstration
project that addresses the CDC program priority
areas 1ndash6
Stroke Networks support a state health department to
increase stroke prevention activities across a group of
three to six contiguous member states with emphasis
on increasing awareness and implementing priority
policy or systems changes across the states
The State HDSP Program is anchored on the
framework of the Socio-ecological Model which
conceptualized the influences of individual
behaviors family and social relationships community
and environmental effects and societal influences
such as policies on health status In order to
promote significant impact for improving the health
of the population interventions should focus on
implementing policy and systems change strategies
that support heart disease and stroke prevention
Policy change can be addressed through a) public
policy (eg establishing certification for hospital-
based stroke centers) or b) organizational policy
(eg businesses providing health benefits plans
that cover preventive services that include blood
pressure control)
System changes are encouraged in three settings
worksites health care and communities An
example of a systems change is when a health
care setting implements electronic records and
patient care management systems that improve the
quality of health care Interventions within systems
are encouraged at the highest level possiblemdashfor
example activities with business coalitions rather
than individual worksites and with managed care
organizations (MCOs) and state medical associations
rather than individual health care sites or physicians
By working at higher levels to affect systems change
states can impact larger segments of the population
Education and awareness efforts to enhance
public understanding and promote actions related
to cardiovascular diseases and the risk factors of
high blood pressure and high cholesterol signs
and symptoms of heart attack and stroke and the
need to call 9-1-1 are also components of capacity
enhancement
An overarching goal of the State HDSP Program
is to address disparities in heart disease and
stroke and the related risk factors using policy and
systems change strategies Based on disparities
(eg raceethnicity gender geographic geography
socioeconomic status) in mortality access to care
or burden of risk factors the State HDSP Program
should identify Priority Populations and implement
interventions to reach those Priority Populations
No one organization will be able to address the
prevention of heart disease and stroke It will require
many organizations working in collaboration if
progress is to be made in accomplishing the Healthy
People 2010 Objectives Collaboration is defined
by the Wilder Foundation as ldquoa mutually beneficial
and well-defined relationship entered into by two
or more organizations to achieve common goals
The relationship includes a commitment to mutual
relationships and goals a jointly developed structure
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20
and shared responsibility mutual authority and
accountability for success and sharing of resources
and rewardsrdquo Developing and maintaining
strategic partnerships are key to the leveraging of
skills and resources to prevent heart disease and
stroke in a comprehensive way The State HDSP
Program has two major roles related to partners
The first is to convene or facilitate collaboration
to develop and implement a comprehensive state
plan and intervention implementation strategies
that addresses heart disease stroke and related
risk factors The second is to develop strategies to
leverage resources and coordinate interventions
with partners that address the six program
priority areas
A logic model has been developed to describe
the State HDSP Program as intended by the CDC
funding to state health departments (see following
page) The model depicts relationships and actions
(eg links between environment and policy
change and individual-level behavioral change)
that are expected to culminate in reduction in
heart disease and stroke
The CDC and state activities are outlined in terms
of capacity building surveillancemonitoring
and interventions Both CDC and state activities
influence changes that lead to short-term
outcomes such as development of a work plan
and strategies for system-level changes effective
implementation of interventions and action by
target audiences and change agents (those who are
in the position to influence policies and systems
such as hospital administrators and MCO decision
makers) These activities and outcomes result in
changes in policy and environmental supports
which in turn influence behavior changes and
improve health status Ultimately these changes
decrease premature death and disability and
eliminate cardiovascular disparities between
general and Priority Populations
The State HDSP logic model also is a tool to guide
program evaluation By identifying the steps
necessary to reach intended outcomes the logic
model provides guidance in evaluating the short and
intermediate outcomes of the program
State evaluation efforts should relate to the National
HDSP Program logic model or to a logic model that
the state develops that complements the national
model and the required program recipient activities
The logic model can also be seen in the CDC
Evaluation Framework for Heart Disease and Stroke
Prevention State Programs at wwwcdcgovdhdsp
Section 2 National Heart Disease and Stroke Prevention State Program Roles In A Public Health Action Plan to Prevent Heart
Disease and Stroke there are four major goals which
are based on Healthy People 2010
Goal 1 Prevention of risk factors
Goal 2 Detection and treatment of risk factors
Goal 3 Early identification and treatment of heart
attacks and strokes
Goal 4 Prevention of recurrent cardiovascular events
CDC-funded State HDSP Programs have a direct
impact on Goals 2 3 and 4 by addressing HDSP
program priority areas 1ndash6 (see Background section)
HDSP programs have a supportive role with other
state health department programs and partners in
addressing Goal 1 Efforts to address Goal 1 related
to tobacco use diabetes obesity poor nutrition
physical inactivity and schools as a worksite should
be done through a supportive or collaborative role
with the state WISEWOMAN diabetes tobacco
nutrition physical activity or coordinated school
health programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
bull State HDSP Programs are encouraged to
coordinate with other programs in ways that
1 Address Goal 1 (eg State HDSP and Nutrition
Programs identify primary prevention messages
related to cholesterol and salt to be included in Nushy
trition Programs where appropriate State HDSP and
Tobacco Programs collaborate to promote use of
state tobacco quit lines State HDSP Program refers
managed care organizations to materials developed
by the Parks and Recreation Department and
Physical Activity Program on safe places to exercise
National HDSP Program Logic Model
State HDSP and WISEWOMAN Programs collaborate
to create systems for educating health care providers
on guidelines focused on risk factor prevention)
2 Enhance inclusion of key messages in the work
of related programs (eg State HDSP Program
works to implement JNC7 guidelines which
include referral to nutrition counseling the
WISEWOMAN Program incorporates education on
signs and symptoms of heart disease and stroke
into ongoing activities the State HDSP Program
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and system change supports
Level bull State bull Local
Settings bull Community bull Health care bull Worksite
Context bull Priority
Populations bull General
populations
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective intervention
implemented focused on
settings and Priority Populations
Change agents
take action
Activate intended audiences
Capa
city B
uildin
gSu
rveil
lance
Inter
vent
ions
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
21
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
16
u
u
u
u
u
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashDeveloping and
Using a Logic Model (wwwcdcgovDHDSP
state_programevaluation_guideslogic_model
htm) a document providing guidance on
the development and use of logic models as
planning and evaluation tools
State Heart Disease and Stroke Prevention
Program Evaluation GuidemdashWriting SMART
Objectives (wwwcdcgovDHDSPstate_
programevaluation_guidessmart_objectives
htm) a document providing guidance to
states on the development of realistic and
measurable objectives
Successful Business Strategies to Prevent Heart
Disease and Stroke Toolkit (wwwcdcgov
dhdsplibrarytoolkitindexhtm) a document
that provides information materials and
tools that state programs can reference and
distribute to businesses primarily through
employer and professional organizations
Heart Disease and Stroke Interactive Maps
(wwwcdcgovdhdsplibrarymapsstatemaps
htm) which present heart disease and stroke
mortality rates by county for the state racial
ethnic group and gender of the userrsquos choice
A Communication Guide for Policy and
Environmental Change (wwwcdcgovdhdsp
libraryheart_stroke_guideindexhtm) which
includes information references and examples
of communication from state programs and
Stroke Addendum to the Communication
Guide (wwwcdcgovdhdsplibraryheart_
stroke_guideindexhtm)
For additional information please visit the CDC
website at wwwcdcgovdhdsp or contact the
Division for Heart Disease and Stroke Prevention
Program Development and Services Branch at
(770) 488-2424
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
17
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
State Heart Disease and Stroke Prevention Program Funding Opportunity Announcement DP07-704 At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
18
Introduction The Funding Opportunity Announcement
(FOA) DP07-704 At-A-Glance provides important
information to assist programs funded under this
announcement to deliver their program as intended
The At-A-Glance highlights aspects of FOA DP07-704
important for all funded programs including
the following
bull Overview of the National Heart Disease and
Stroke Prevention Program
bull Heart Disease and Stroke Prevention State
Program roles
bull Performance measures for Capacity Building Basic
Implementation Optional Funding for Capacity
Building programs and Stroke Networks
bull Funded program reporting requirements
bull Budgetfunding guidance
bull National and administrative policy requirements
If a program needs a copy of the full document
it should contact its project officer (see Program
Contacts section of the full National Heart Disease
and Stroke Prevention Program Staff Orientation
Manual) to fulfill that request
Section 1 Background In 1998 the US Congress provided funding for
CDC to initiate a national state-based cardiovascular
health program The Senate Appropriations
Committee in 2005 encouraged CDC to create the
Division for Heart Disease and Stroke Prevention and
increased resources enabling CDC to reach 32 of the
50 states and the District of Columbia with funding
for heart disease and stroke prevention As of 2008
the Heart Disease and Stroke Prevention (HDSP)
program funds 41 states and the District of Columbia
As the Division for Heart Disease and Stroke
Prevention developed so did the focus of the State
HDSP Program Focusing on the six program priority
areas (noted below) should impact morbidity and
mortality of these diseases State programs should
increase heart disease and stroke prevention policies
and systems change with the potential to impact
the general population and Priority Populations
(see Prevention Works CDC Strategies for a Heart-
healthy and Stroke-free America wwwCDCgov
dhdsplibrary) For more information on the CDC
State HDSP Program visit wwwcdcgovdhdspState_
programindexhtm
A Public Health Action Plan to Prevent Heart Disease
and Stroke (see wwwCDCgovdhdsplibrary)
documents the multiple intervention opportunities
for preventing heart disease and stroke It is
important to work with partners collaboratively in
leveraging resources to address the multiple risk
factors that are associated with these diseases
Announcement DP07-704 supports program
components considered essential to enhancing
the leadership of state health departments in
heart disease and stroke prevention It provides
for the funding of capacity building and basic
implementation programs as well as projects such as
the Optional Funding for Capacity Building Programs
and Stroke Networks
A capacity building program develops the foundation
for a comprehensive cardiovascular disease prevention
program through such activities as partnership
development definition of the burden and
development of a state plan A basic implementation
program enhances capacity building activities and
implements disseminates and evaluates intervention
activities that address the state plan objectives and the
CDC program priority areas 1ndash6
1 Increase control of high blood pressure primarily
in adults and older adults
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19
2 Increase control of high blood cholesterol
primarily in adults and older adults
3 Increase knowledge of signs and symptoms for
heart attack and stroke and the importance of
calling 9-1-1
4 Improve emergency response
5 Improve quality of heart disease and stroke care
6 Eliminate disparities in terms of race ethnicity
gender geography or socioeconomic status
Optional Funding for Capacity Building Programs
provides support to programs to implement an
evidence-based or promising practice demonstration
project that addresses the CDC program priority
areas 1ndash6
Stroke Networks support a state health department to
increase stroke prevention activities across a group of
three to six contiguous member states with emphasis
on increasing awareness and implementing priority
policy or systems changes across the states
The State HDSP Program is anchored on the
framework of the Socio-ecological Model which
conceptualized the influences of individual
behaviors family and social relationships community
and environmental effects and societal influences
such as policies on health status In order to
promote significant impact for improving the health
of the population interventions should focus on
implementing policy and systems change strategies
that support heart disease and stroke prevention
Policy change can be addressed through a) public
policy (eg establishing certification for hospital-
based stroke centers) or b) organizational policy
(eg businesses providing health benefits plans
that cover preventive services that include blood
pressure control)
System changes are encouraged in three settings
worksites health care and communities An
example of a systems change is when a health
care setting implements electronic records and
patient care management systems that improve the
quality of health care Interventions within systems
are encouraged at the highest level possiblemdashfor
example activities with business coalitions rather
than individual worksites and with managed care
organizations (MCOs) and state medical associations
rather than individual health care sites or physicians
By working at higher levels to affect systems change
states can impact larger segments of the population
Education and awareness efforts to enhance
public understanding and promote actions related
to cardiovascular diseases and the risk factors of
high blood pressure and high cholesterol signs
and symptoms of heart attack and stroke and the
need to call 9-1-1 are also components of capacity
enhancement
An overarching goal of the State HDSP Program
is to address disparities in heart disease and
stroke and the related risk factors using policy and
systems change strategies Based on disparities
(eg raceethnicity gender geographic geography
socioeconomic status) in mortality access to care
or burden of risk factors the State HDSP Program
should identify Priority Populations and implement
interventions to reach those Priority Populations
No one organization will be able to address the
prevention of heart disease and stroke It will require
many organizations working in collaboration if
progress is to be made in accomplishing the Healthy
People 2010 Objectives Collaboration is defined
by the Wilder Foundation as ldquoa mutually beneficial
and well-defined relationship entered into by two
or more organizations to achieve common goals
The relationship includes a commitment to mutual
relationships and goals a jointly developed structure
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20
and shared responsibility mutual authority and
accountability for success and sharing of resources
and rewardsrdquo Developing and maintaining
strategic partnerships are key to the leveraging of
skills and resources to prevent heart disease and
stroke in a comprehensive way The State HDSP
Program has two major roles related to partners
The first is to convene or facilitate collaboration
to develop and implement a comprehensive state
plan and intervention implementation strategies
that addresses heart disease stroke and related
risk factors The second is to develop strategies to
leverage resources and coordinate interventions
with partners that address the six program
priority areas
A logic model has been developed to describe
the State HDSP Program as intended by the CDC
funding to state health departments (see following
page) The model depicts relationships and actions
(eg links between environment and policy
change and individual-level behavioral change)
that are expected to culminate in reduction in
heart disease and stroke
The CDC and state activities are outlined in terms
of capacity building surveillancemonitoring
and interventions Both CDC and state activities
influence changes that lead to short-term
outcomes such as development of a work plan
and strategies for system-level changes effective
implementation of interventions and action by
target audiences and change agents (those who are
in the position to influence policies and systems
such as hospital administrators and MCO decision
makers) These activities and outcomes result in
changes in policy and environmental supports
which in turn influence behavior changes and
improve health status Ultimately these changes
decrease premature death and disability and
eliminate cardiovascular disparities between
general and Priority Populations
The State HDSP logic model also is a tool to guide
program evaluation By identifying the steps
necessary to reach intended outcomes the logic
model provides guidance in evaluating the short and
intermediate outcomes of the program
State evaluation efforts should relate to the National
HDSP Program logic model or to a logic model that
the state develops that complements the national
model and the required program recipient activities
The logic model can also be seen in the CDC
Evaluation Framework for Heart Disease and Stroke
Prevention State Programs at wwwcdcgovdhdsp
Section 2 National Heart Disease and Stroke Prevention State Program Roles In A Public Health Action Plan to Prevent Heart
Disease and Stroke there are four major goals which
are based on Healthy People 2010
Goal 1 Prevention of risk factors
Goal 2 Detection and treatment of risk factors
Goal 3 Early identification and treatment of heart
attacks and strokes
Goal 4 Prevention of recurrent cardiovascular events
CDC-funded State HDSP Programs have a direct
impact on Goals 2 3 and 4 by addressing HDSP
program priority areas 1ndash6 (see Background section)
HDSP programs have a supportive role with other
state health department programs and partners in
addressing Goal 1 Efforts to address Goal 1 related
to tobacco use diabetes obesity poor nutrition
physical inactivity and schools as a worksite should
be done through a supportive or collaborative role
with the state WISEWOMAN diabetes tobacco
nutrition physical activity or coordinated school
health programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
bull State HDSP Programs are encouraged to
coordinate with other programs in ways that
1 Address Goal 1 (eg State HDSP and Nutrition
Programs identify primary prevention messages
related to cholesterol and salt to be included in Nushy
trition Programs where appropriate State HDSP and
Tobacco Programs collaborate to promote use of
state tobacco quit lines State HDSP Program refers
managed care organizations to materials developed
by the Parks and Recreation Department and
Physical Activity Program on safe places to exercise
National HDSP Program Logic Model
State HDSP and WISEWOMAN Programs collaborate
to create systems for educating health care providers
on guidelines focused on risk factor prevention)
2 Enhance inclusion of key messages in the work
of related programs (eg State HDSP Program
works to implement JNC7 guidelines which
include referral to nutrition counseling the
WISEWOMAN Program incorporates education on
signs and symptoms of heart disease and stroke
into ongoing activities the State HDSP Program
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and system change supports
Level bull State bull Local
Settings bull Community bull Health care bull Worksite
Context bull Priority
Populations bull General
populations
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective intervention
implemented focused on
settings and Priority Populations
Change agents
take action
Activate intended audiences
Capa
city B
uildin
gSu
rveil
lance
Inter
vent
ions
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
21
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
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23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
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25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
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26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
17
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
State Heart Disease and Stroke Prevention Program Funding Opportunity Announcement DP07-704 At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
18
Introduction The Funding Opportunity Announcement
(FOA) DP07-704 At-A-Glance provides important
information to assist programs funded under this
announcement to deliver their program as intended
The At-A-Glance highlights aspects of FOA DP07-704
important for all funded programs including
the following
bull Overview of the National Heart Disease and
Stroke Prevention Program
bull Heart Disease and Stroke Prevention State
Program roles
bull Performance measures for Capacity Building Basic
Implementation Optional Funding for Capacity
Building programs and Stroke Networks
bull Funded program reporting requirements
bull Budgetfunding guidance
bull National and administrative policy requirements
If a program needs a copy of the full document
it should contact its project officer (see Program
Contacts section of the full National Heart Disease
and Stroke Prevention Program Staff Orientation
Manual) to fulfill that request
Section 1 Background In 1998 the US Congress provided funding for
CDC to initiate a national state-based cardiovascular
health program The Senate Appropriations
Committee in 2005 encouraged CDC to create the
Division for Heart Disease and Stroke Prevention and
increased resources enabling CDC to reach 32 of the
50 states and the District of Columbia with funding
for heart disease and stroke prevention As of 2008
the Heart Disease and Stroke Prevention (HDSP)
program funds 41 states and the District of Columbia
As the Division for Heart Disease and Stroke
Prevention developed so did the focus of the State
HDSP Program Focusing on the six program priority
areas (noted below) should impact morbidity and
mortality of these diseases State programs should
increase heart disease and stroke prevention policies
and systems change with the potential to impact
the general population and Priority Populations
(see Prevention Works CDC Strategies for a Heart-
healthy and Stroke-free America wwwCDCgov
dhdsplibrary) For more information on the CDC
State HDSP Program visit wwwcdcgovdhdspState_
programindexhtm
A Public Health Action Plan to Prevent Heart Disease
and Stroke (see wwwCDCgovdhdsplibrary)
documents the multiple intervention opportunities
for preventing heart disease and stroke It is
important to work with partners collaboratively in
leveraging resources to address the multiple risk
factors that are associated with these diseases
Announcement DP07-704 supports program
components considered essential to enhancing
the leadership of state health departments in
heart disease and stroke prevention It provides
for the funding of capacity building and basic
implementation programs as well as projects such as
the Optional Funding for Capacity Building Programs
and Stroke Networks
A capacity building program develops the foundation
for a comprehensive cardiovascular disease prevention
program through such activities as partnership
development definition of the burden and
development of a state plan A basic implementation
program enhances capacity building activities and
implements disseminates and evaluates intervention
activities that address the state plan objectives and the
CDC program priority areas 1ndash6
1 Increase control of high blood pressure primarily
in adults and older adults
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
19
2 Increase control of high blood cholesterol
primarily in adults and older adults
3 Increase knowledge of signs and symptoms for
heart attack and stroke and the importance of
calling 9-1-1
4 Improve emergency response
5 Improve quality of heart disease and stroke care
6 Eliminate disparities in terms of race ethnicity
gender geography or socioeconomic status
Optional Funding for Capacity Building Programs
provides support to programs to implement an
evidence-based or promising practice demonstration
project that addresses the CDC program priority
areas 1ndash6
Stroke Networks support a state health department to
increase stroke prevention activities across a group of
three to six contiguous member states with emphasis
on increasing awareness and implementing priority
policy or systems changes across the states
The State HDSP Program is anchored on the
framework of the Socio-ecological Model which
conceptualized the influences of individual
behaviors family and social relationships community
and environmental effects and societal influences
such as policies on health status In order to
promote significant impact for improving the health
of the population interventions should focus on
implementing policy and systems change strategies
that support heart disease and stroke prevention
Policy change can be addressed through a) public
policy (eg establishing certification for hospital-
based stroke centers) or b) organizational policy
(eg businesses providing health benefits plans
that cover preventive services that include blood
pressure control)
System changes are encouraged in three settings
worksites health care and communities An
example of a systems change is when a health
care setting implements electronic records and
patient care management systems that improve the
quality of health care Interventions within systems
are encouraged at the highest level possiblemdashfor
example activities with business coalitions rather
than individual worksites and with managed care
organizations (MCOs) and state medical associations
rather than individual health care sites or physicians
By working at higher levels to affect systems change
states can impact larger segments of the population
Education and awareness efforts to enhance
public understanding and promote actions related
to cardiovascular diseases and the risk factors of
high blood pressure and high cholesterol signs
and symptoms of heart attack and stroke and the
need to call 9-1-1 are also components of capacity
enhancement
An overarching goal of the State HDSP Program
is to address disparities in heart disease and
stroke and the related risk factors using policy and
systems change strategies Based on disparities
(eg raceethnicity gender geographic geography
socioeconomic status) in mortality access to care
or burden of risk factors the State HDSP Program
should identify Priority Populations and implement
interventions to reach those Priority Populations
No one organization will be able to address the
prevention of heart disease and stroke It will require
many organizations working in collaboration if
progress is to be made in accomplishing the Healthy
People 2010 Objectives Collaboration is defined
by the Wilder Foundation as ldquoa mutually beneficial
and well-defined relationship entered into by two
or more organizations to achieve common goals
The relationship includes a commitment to mutual
relationships and goals a jointly developed structure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
20
and shared responsibility mutual authority and
accountability for success and sharing of resources
and rewardsrdquo Developing and maintaining
strategic partnerships are key to the leveraging of
skills and resources to prevent heart disease and
stroke in a comprehensive way The State HDSP
Program has two major roles related to partners
The first is to convene or facilitate collaboration
to develop and implement a comprehensive state
plan and intervention implementation strategies
that addresses heart disease stroke and related
risk factors The second is to develop strategies to
leverage resources and coordinate interventions
with partners that address the six program
priority areas
A logic model has been developed to describe
the State HDSP Program as intended by the CDC
funding to state health departments (see following
page) The model depicts relationships and actions
(eg links between environment and policy
change and individual-level behavioral change)
that are expected to culminate in reduction in
heart disease and stroke
The CDC and state activities are outlined in terms
of capacity building surveillancemonitoring
and interventions Both CDC and state activities
influence changes that lead to short-term
outcomes such as development of a work plan
and strategies for system-level changes effective
implementation of interventions and action by
target audiences and change agents (those who are
in the position to influence policies and systems
such as hospital administrators and MCO decision
makers) These activities and outcomes result in
changes in policy and environmental supports
which in turn influence behavior changes and
improve health status Ultimately these changes
decrease premature death and disability and
eliminate cardiovascular disparities between
general and Priority Populations
The State HDSP logic model also is a tool to guide
program evaluation By identifying the steps
necessary to reach intended outcomes the logic
model provides guidance in evaluating the short and
intermediate outcomes of the program
State evaluation efforts should relate to the National
HDSP Program logic model or to a logic model that
the state develops that complements the national
model and the required program recipient activities
The logic model can also be seen in the CDC
Evaluation Framework for Heart Disease and Stroke
Prevention State Programs at wwwcdcgovdhdsp
Section 2 National Heart Disease and Stroke Prevention State Program Roles In A Public Health Action Plan to Prevent Heart
Disease and Stroke there are four major goals which
are based on Healthy People 2010
Goal 1 Prevention of risk factors
Goal 2 Detection and treatment of risk factors
Goal 3 Early identification and treatment of heart
attacks and strokes
Goal 4 Prevention of recurrent cardiovascular events
CDC-funded State HDSP Programs have a direct
impact on Goals 2 3 and 4 by addressing HDSP
program priority areas 1ndash6 (see Background section)
HDSP programs have a supportive role with other
state health department programs and partners in
addressing Goal 1 Efforts to address Goal 1 related
to tobacco use diabetes obesity poor nutrition
physical inactivity and schools as a worksite should
be done through a supportive or collaborative role
with the state WISEWOMAN diabetes tobacco
nutrition physical activity or coordinated school
health programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
bull State HDSP Programs are encouraged to
coordinate with other programs in ways that
1 Address Goal 1 (eg State HDSP and Nutrition
Programs identify primary prevention messages
related to cholesterol and salt to be included in Nushy
trition Programs where appropriate State HDSP and
Tobacco Programs collaborate to promote use of
state tobacco quit lines State HDSP Program refers
managed care organizations to materials developed
by the Parks and Recreation Department and
Physical Activity Program on safe places to exercise
National HDSP Program Logic Model
State HDSP and WISEWOMAN Programs collaborate
to create systems for educating health care providers
on guidelines focused on risk factor prevention)
2 Enhance inclusion of key messages in the work
of related programs (eg State HDSP Program
works to implement JNC7 guidelines which
include referral to nutrition counseling the
WISEWOMAN Program incorporates education on
signs and symptoms of heart disease and stroke
into ongoing activities the State HDSP Program
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and system change supports
Level bull State bull Local
Settings bull Community bull Health care bull Worksite
Context bull Priority
Populations bull General
populations
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective intervention
implemented focused on
settings and Priority Populations
Change agents
take action
Activate intended audiences
Capa
city B
uildin
gSu
rveil
lance
Inter
vent
ions
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
21
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
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18
Introduction The Funding Opportunity Announcement
(FOA) DP07-704 At-A-Glance provides important
information to assist programs funded under this
announcement to deliver their program as intended
The At-A-Glance highlights aspects of FOA DP07-704
important for all funded programs including
the following
bull Overview of the National Heart Disease and
Stroke Prevention Program
bull Heart Disease and Stroke Prevention State
Program roles
bull Performance measures for Capacity Building Basic
Implementation Optional Funding for Capacity
Building programs and Stroke Networks
bull Funded program reporting requirements
bull Budgetfunding guidance
bull National and administrative policy requirements
If a program needs a copy of the full document
it should contact its project officer (see Program
Contacts section of the full National Heart Disease
and Stroke Prevention Program Staff Orientation
Manual) to fulfill that request
Section 1 Background In 1998 the US Congress provided funding for
CDC to initiate a national state-based cardiovascular
health program The Senate Appropriations
Committee in 2005 encouraged CDC to create the
Division for Heart Disease and Stroke Prevention and
increased resources enabling CDC to reach 32 of the
50 states and the District of Columbia with funding
for heart disease and stroke prevention As of 2008
the Heart Disease and Stroke Prevention (HDSP)
program funds 41 states and the District of Columbia
As the Division for Heart Disease and Stroke
Prevention developed so did the focus of the State
HDSP Program Focusing on the six program priority
areas (noted below) should impact morbidity and
mortality of these diseases State programs should
increase heart disease and stroke prevention policies
and systems change with the potential to impact
the general population and Priority Populations
(see Prevention Works CDC Strategies for a Heart-
healthy and Stroke-free America wwwCDCgov
dhdsplibrary) For more information on the CDC
State HDSP Program visit wwwcdcgovdhdspState_
programindexhtm
A Public Health Action Plan to Prevent Heart Disease
and Stroke (see wwwCDCgovdhdsplibrary)
documents the multiple intervention opportunities
for preventing heart disease and stroke It is
important to work with partners collaboratively in
leveraging resources to address the multiple risk
factors that are associated with these diseases
Announcement DP07-704 supports program
components considered essential to enhancing
the leadership of state health departments in
heart disease and stroke prevention It provides
for the funding of capacity building and basic
implementation programs as well as projects such as
the Optional Funding for Capacity Building Programs
and Stroke Networks
A capacity building program develops the foundation
for a comprehensive cardiovascular disease prevention
program through such activities as partnership
development definition of the burden and
development of a state plan A basic implementation
program enhances capacity building activities and
implements disseminates and evaluates intervention
activities that address the state plan objectives and the
CDC program priority areas 1ndash6
1 Increase control of high blood pressure primarily
in adults and older adults
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19
2 Increase control of high blood cholesterol
primarily in adults and older adults
3 Increase knowledge of signs and symptoms for
heart attack and stroke and the importance of
calling 9-1-1
4 Improve emergency response
5 Improve quality of heart disease and stroke care
6 Eliminate disparities in terms of race ethnicity
gender geography or socioeconomic status
Optional Funding for Capacity Building Programs
provides support to programs to implement an
evidence-based or promising practice demonstration
project that addresses the CDC program priority
areas 1ndash6
Stroke Networks support a state health department to
increase stroke prevention activities across a group of
three to six contiguous member states with emphasis
on increasing awareness and implementing priority
policy or systems changes across the states
The State HDSP Program is anchored on the
framework of the Socio-ecological Model which
conceptualized the influences of individual
behaviors family and social relationships community
and environmental effects and societal influences
such as policies on health status In order to
promote significant impact for improving the health
of the population interventions should focus on
implementing policy and systems change strategies
that support heart disease and stroke prevention
Policy change can be addressed through a) public
policy (eg establishing certification for hospital-
based stroke centers) or b) organizational policy
(eg businesses providing health benefits plans
that cover preventive services that include blood
pressure control)
System changes are encouraged in three settings
worksites health care and communities An
example of a systems change is when a health
care setting implements electronic records and
patient care management systems that improve the
quality of health care Interventions within systems
are encouraged at the highest level possiblemdashfor
example activities with business coalitions rather
than individual worksites and with managed care
organizations (MCOs) and state medical associations
rather than individual health care sites or physicians
By working at higher levels to affect systems change
states can impact larger segments of the population
Education and awareness efforts to enhance
public understanding and promote actions related
to cardiovascular diseases and the risk factors of
high blood pressure and high cholesterol signs
and symptoms of heart attack and stroke and the
need to call 9-1-1 are also components of capacity
enhancement
An overarching goal of the State HDSP Program
is to address disparities in heart disease and
stroke and the related risk factors using policy and
systems change strategies Based on disparities
(eg raceethnicity gender geographic geography
socioeconomic status) in mortality access to care
or burden of risk factors the State HDSP Program
should identify Priority Populations and implement
interventions to reach those Priority Populations
No one organization will be able to address the
prevention of heart disease and stroke It will require
many organizations working in collaboration if
progress is to be made in accomplishing the Healthy
People 2010 Objectives Collaboration is defined
by the Wilder Foundation as ldquoa mutually beneficial
and well-defined relationship entered into by two
or more organizations to achieve common goals
The relationship includes a commitment to mutual
relationships and goals a jointly developed structure
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20
and shared responsibility mutual authority and
accountability for success and sharing of resources
and rewardsrdquo Developing and maintaining
strategic partnerships are key to the leveraging of
skills and resources to prevent heart disease and
stroke in a comprehensive way The State HDSP
Program has two major roles related to partners
The first is to convene or facilitate collaboration
to develop and implement a comprehensive state
plan and intervention implementation strategies
that addresses heart disease stroke and related
risk factors The second is to develop strategies to
leverage resources and coordinate interventions
with partners that address the six program
priority areas
A logic model has been developed to describe
the State HDSP Program as intended by the CDC
funding to state health departments (see following
page) The model depicts relationships and actions
(eg links between environment and policy
change and individual-level behavioral change)
that are expected to culminate in reduction in
heart disease and stroke
The CDC and state activities are outlined in terms
of capacity building surveillancemonitoring
and interventions Both CDC and state activities
influence changes that lead to short-term
outcomes such as development of a work plan
and strategies for system-level changes effective
implementation of interventions and action by
target audiences and change agents (those who are
in the position to influence policies and systems
such as hospital administrators and MCO decision
makers) These activities and outcomes result in
changes in policy and environmental supports
which in turn influence behavior changes and
improve health status Ultimately these changes
decrease premature death and disability and
eliminate cardiovascular disparities between
general and Priority Populations
The State HDSP logic model also is a tool to guide
program evaluation By identifying the steps
necessary to reach intended outcomes the logic
model provides guidance in evaluating the short and
intermediate outcomes of the program
State evaluation efforts should relate to the National
HDSP Program logic model or to a logic model that
the state develops that complements the national
model and the required program recipient activities
The logic model can also be seen in the CDC
Evaluation Framework for Heart Disease and Stroke
Prevention State Programs at wwwcdcgovdhdsp
Section 2 National Heart Disease and Stroke Prevention State Program Roles In A Public Health Action Plan to Prevent Heart
Disease and Stroke there are four major goals which
are based on Healthy People 2010
Goal 1 Prevention of risk factors
Goal 2 Detection and treatment of risk factors
Goal 3 Early identification and treatment of heart
attacks and strokes
Goal 4 Prevention of recurrent cardiovascular events
CDC-funded State HDSP Programs have a direct
impact on Goals 2 3 and 4 by addressing HDSP
program priority areas 1ndash6 (see Background section)
HDSP programs have a supportive role with other
state health department programs and partners in
addressing Goal 1 Efforts to address Goal 1 related
to tobacco use diabetes obesity poor nutrition
physical inactivity and schools as a worksite should
be done through a supportive or collaborative role
with the state WISEWOMAN diabetes tobacco
nutrition physical activity or coordinated school
health programs
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bull State HDSP Programs are encouraged to
coordinate with other programs in ways that
1 Address Goal 1 (eg State HDSP and Nutrition
Programs identify primary prevention messages
related to cholesterol and salt to be included in Nushy
trition Programs where appropriate State HDSP and
Tobacco Programs collaborate to promote use of
state tobacco quit lines State HDSP Program refers
managed care organizations to materials developed
by the Parks and Recreation Department and
Physical Activity Program on safe places to exercise
National HDSP Program Logic Model
State HDSP and WISEWOMAN Programs collaborate
to create systems for educating health care providers
on guidelines focused on risk factor prevention)
2 Enhance inclusion of key messages in the work
of related programs (eg State HDSP Program
works to implement JNC7 guidelines which
include referral to nutrition counseling the
WISEWOMAN Program incorporates education on
signs and symptoms of heart disease and stroke
into ongoing activities the State HDSP Program
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and system change supports
Level bull State bull Local
Settings bull Community bull Health care bull Worksite
Context bull Priority
Populations bull General
populations
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective intervention
implemented focused on
settings and Priority Populations
Change agents
take action
Activate intended audiences
Capa
city B
uildin
gSu
rveil
lance
Inter
vent
ions
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
21
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encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
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23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
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24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
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25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
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26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
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27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
19
2 Increase control of high blood cholesterol
primarily in adults and older adults
3 Increase knowledge of signs and symptoms for
heart attack and stroke and the importance of
calling 9-1-1
4 Improve emergency response
5 Improve quality of heart disease and stroke care
6 Eliminate disparities in terms of race ethnicity
gender geography or socioeconomic status
Optional Funding for Capacity Building Programs
provides support to programs to implement an
evidence-based or promising practice demonstration
project that addresses the CDC program priority
areas 1ndash6
Stroke Networks support a state health department to
increase stroke prevention activities across a group of
three to six contiguous member states with emphasis
on increasing awareness and implementing priority
policy or systems changes across the states
The State HDSP Program is anchored on the
framework of the Socio-ecological Model which
conceptualized the influences of individual
behaviors family and social relationships community
and environmental effects and societal influences
such as policies on health status In order to
promote significant impact for improving the health
of the population interventions should focus on
implementing policy and systems change strategies
that support heart disease and stroke prevention
Policy change can be addressed through a) public
policy (eg establishing certification for hospital-
based stroke centers) or b) organizational policy
(eg businesses providing health benefits plans
that cover preventive services that include blood
pressure control)
System changes are encouraged in three settings
worksites health care and communities An
example of a systems change is when a health
care setting implements electronic records and
patient care management systems that improve the
quality of health care Interventions within systems
are encouraged at the highest level possiblemdashfor
example activities with business coalitions rather
than individual worksites and with managed care
organizations (MCOs) and state medical associations
rather than individual health care sites or physicians
By working at higher levels to affect systems change
states can impact larger segments of the population
Education and awareness efforts to enhance
public understanding and promote actions related
to cardiovascular diseases and the risk factors of
high blood pressure and high cholesterol signs
and symptoms of heart attack and stroke and the
need to call 9-1-1 are also components of capacity
enhancement
An overarching goal of the State HDSP Program
is to address disparities in heart disease and
stroke and the related risk factors using policy and
systems change strategies Based on disparities
(eg raceethnicity gender geographic geography
socioeconomic status) in mortality access to care
or burden of risk factors the State HDSP Program
should identify Priority Populations and implement
interventions to reach those Priority Populations
No one organization will be able to address the
prevention of heart disease and stroke It will require
many organizations working in collaboration if
progress is to be made in accomplishing the Healthy
People 2010 Objectives Collaboration is defined
by the Wilder Foundation as ldquoa mutually beneficial
and well-defined relationship entered into by two
or more organizations to achieve common goals
The relationship includes a commitment to mutual
relationships and goals a jointly developed structure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
20
and shared responsibility mutual authority and
accountability for success and sharing of resources
and rewardsrdquo Developing and maintaining
strategic partnerships are key to the leveraging of
skills and resources to prevent heart disease and
stroke in a comprehensive way The State HDSP
Program has two major roles related to partners
The first is to convene or facilitate collaboration
to develop and implement a comprehensive state
plan and intervention implementation strategies
that addresses heart disease stroke and related
risk factors The second is to develop strategies to
leverage resources and coordinate interventions
with partners that address the six program
priority areas
A logic model has been developed to describe
the State HDSP Program as intended by the CDC
funding to state health departments (see following
page) The model depicts relationships and actions
(eg links between environment and policy
change and individual-level behavioral change)
that are expected to culminate in reduction in
heart disease and stroke
The CDC and state activities are outlined in terms
of capacity building surveillancemonitoring
and interventions Both CDC and state activities
influence changes that lead to short-term
outcomes such as development of a work plan
and strategies for system-level changes effective
implementation of interventions and action by
target audiences and change agents (those who are
in the position to influence policies and systems
such as hospital administrators and MCO decision
makers) These activities and outcomes result in
changes in policy and environmental supports
which in turn influence behavior changes and
improve health status Ultimately these changes
decrease premature death and disability and
eliminate cardiovascular disparities between
general and Priority Populations
The State HDSP logic model also is a tool to guide
program evaluation By identifying the steps
necessary to reach intended outcomes the logic
model provides guidance in evaluating the short and
intermediate outcomes of the program
State evaluation efforts should relate to the National
HDSP Program logic model or to a logic model that
the state develops that complements the national
model and the required program recipient activities
The logic model can also be seen in the CDC
Evaluation Framework for Heart Disease and Stroke
Prevention State Programs at wwwcdcgovdhdsp
Section 2 National Heart Disease and Stroke Prevention State Program Roles In A Public Health Action Plan to Prevent Heart
Disease and Stroke there are four major goals which
are based on Healthy People 2010
Goal 1 Prevention of risk factors
Goal 2 Detection and treatment of risk factors
Goal 3 Early identification and treatment of heart
attacks and strokes
Goal 4 Prevention of recurrent cardiovascular events
CDC-funded State HDSP Programs have a direct
impact on Goals 2 3 and 4 by addressing HDSP
program priority areas 1ndash6 (see Background section)
HDSP programs have a supportive role with other
state health department programs and partners in
addressing Goal 1 Efforts to address Goal 1 related
to tobacco use diabetes obesity poor nutrition
physical inactivity and schools as a worksite should
be done through a supportive or collaborative role
with the state WISEWOMAN diabetes tobacco
nutrition physical activity or coordinated school
health programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
bull State HDSP Programs are encouraged to
coordinate with other programs in ways that
1 Address Goal 1 (eg State HDSP and Nutrition
Programs identify primary prevention messages
related to cholesterol and salt to be included in Nushy
trition Programs where appropriate State HDSP and
Tobacco Programs collaborate to promote use of
state tobacco quit lines State HDSP Program refers
managed care organizations to materials developed
by the Parks and Recreation Department and
Physical Activity Program on safe places to exercise
National HDSP Program Logic Model
State HDSP and WISEWOMAN Programs collaborate
to create systems for educating health care providers
on guidelines focused on risk factor prevention)
2 Enhance inclusion of key messages in the work
of related programs (eg State HDSP Program
works to implement JNC7 guidelines which
include referral to nutrition counseling the
WISEWOMAN Program incorporates education on
signs and symptoms of heart disease and stroke
into ongoing activities the State HDSP Program
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and system change supports
Level bull State bull Local
Settings bull Community bull Health care bull Worksite
Context bull Priority
Populations bull General
populations
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective intervention
implemented focused on
settings and Priority Populations
Change agents
take action
Activate intended audiences
Capa
city B
uildin
gSu
rveil
lance
Inter
vent
ions
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
21
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
20
and shared responsibility mutual authority and
accountability for success and sharing of resources
and rewardsrdquo Developing and maintaining
strategic partnerships are key to the leveraging of
skills and resources to prevent heart disease and
stroke in a comprehensive way The State HDSP
Program has two major roles related to partners
The first is to convene or facilitate collaboration
to develop and implement a comprehensive state
plan and intervention implementation strategies
that addresses heart disease stroke and related
risk factors The second is to develop strategies to
leverage resources and coordinate interventions
with partners that address the six program
priority areas
A logic model has been developed to describe
the State HDSP Program as intended by the CDC
funding to state health departments (see following
page) The model depicts relationships and actions
(eg links between environment and policy
change and individual-level behavioral change)
that are expected to culminate in reduction in
heart disease and stroke
The CDC and state activities are outlined in terms
of capacity building surveillancemonitoring
and interventions Both CDC and state activities
influence changes that lead to short-term
outcomes such as development of a work plan
and strategies for system-level changes effective
implementation of interventions and action by
target audiences and change agents (those who are
in the position to influence policies and systems
such as hospital administrators and MCO decision
makers) These activities and outcomes result in
changes in policy and environmental supports
which in turn influence behavior changes and
improve health status Ultimately these changes
decrease premature death and disability and
eliminate cardiovascular disparities between
general and Priority Populations
The State HDSP logic model also is a tool to guide
program evaluation By identifying the steps
necessary to reach intended outcomes the logic
model provides guidance in evaluating the short and
intermediate outcomes of the program
State evaluation efforts should relate to the National
HDSP Program logic model or to a logic model that
the state develops that complements the national
model and the required program recipient activities
The logic model can also be seen in the CDC
Evaluation Framework for Heart Disease and Stroke
Prevention State Programs at wwwcdcgovdhdsp
Section 2 National Heart Disease and Stroke Prevention State Program Roles In A Public Health Action Plan to Prevent Heart
Disease and Stroke there are four major goals which
are based on Healthy People 2010
Goal 1 Prevention of risk factors
Goal 2 Detection and treatment of risk factors
Goal 3 Early identification and treatment of heart
attacks and strokes
Goal 4 Prevention of recurrent cardiovascular events
CDC-funded State HDSP Programs have a direct
impact on Goals 2 3 and 4 by addressing HDSP
program priority areas 1ndash6 (see Background section)
HDSP programs have a supportive role with other
state health department programs and partners in
addressing Goal 1 Efforts to address Goal 1 related
to tobacco use diabetes obesity poor nutrition
physical inactivity and schools as a worksite should
be done through a supportive or collaborative role
with the state WISEWOMAN diabetes tobacco
nutrition physical activity or coordinated school
health programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
bull State HDSP Programs are encouraged to
coordinate with other programs in ways that
1 Address Goal 1 (eg State HDSP and Nutrition
Programs identify primary prevention messages
related to cholesterol and salt to be included in Nushy
trition Programs where appropriate State HDSP and
Tobacco Programs collaborate to promote use of
state tobacco quit lines State HDSP Program refers
managed care organizations to materials developed
by the Parks and Recreation Department and
Physical Activity Program on safe places to exercise
National HDSP Program Logic Model
State HDSP and WISEWOMAN Programs collaborate
to create systems for educating health care providers
on guidelines focused on risk factor prevention)
2 Enhance inclusion of key messages in the work
of related programs (eg State HDSP Program
works to implement JNC7 guidelines which
include referral to nutrition counseling the
WISEWOMAN Program incorporates education on
signs and symptoms of heart disease and stroke
into ongoing activities the State HDSP Program
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and system change supports
Level bull State bull Local
Settings bull Community bull Health care bull Worksite
Context bull Priority
Populations bull General
populations
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective intervention
implemented focused on
settings and Priority Populations
Change agents
take action
Activate intended audiences
Capa
city B
uildin
gSu
rveil
lance
Inter
vent
ions
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
21
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
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23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
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26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
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53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
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54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
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55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
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56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
bull State HDSP Programs are encouraged to
coordinate with other programs in ways that
1 Address Goal 1 (eg State HDSP and Nutrition
Programs identify primary prevention messages
related to cholesterol and salt to be included in Nushy
trition Programs where appropriate State HDSP and
Tobacco Programs collaborate to promote use of
state tobacco quit lines State HDSP Program refers
managed care organizations to materials developed
by the Parks and Recreation Department and
Physical Activity Program on safe places to exercise
National HDSP Program Logic Model
State HDSP and WISEWOMAN Programs collaborate
to create systems for educating health care providers
on guidelines focused on risk factor prevention)
2 Enhance inclusion of key messages in the work
of related programs (eg State HDSP Program
works to implement JNC7 guidelines which
include referral to nutrition counseling the
WISEWOMAN Program incorporates education on
signs and symptoms of heart disease and stroke
into ongoing activities the State HDSP Program
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and system change supports
Level bull State bull Local
Settings bull Community bull Health care bull Worksite
Context bull Priority
Populations bull General
populations
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective intervention
implemented focused on
settings and Priority Populations
Change agents
take action
Activate intended audiences
Capa
city B
uildin
gSu
rveil
lance
Inter
vent
ions
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
21
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encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
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23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
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24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
encourages implementation of patient record
systems that include family history)
3 Coordinate work with partners (eg multiple
health department programs that work with
American Heart Association coordinate efforts
with this partner where possible)
4 Coordinate work within settings (eg programs
with related interests in healthy workplaces
coordinate efforts to engage worksites or business
coalitions State HDSP and other chronic disease
programs work collaboratively with community
health centers to implement systems change to
increase blood pressure control)
5 Maximize the public health benefit from the use
of CDC funding within approved budget line
items to enhance the statersquos ability to achieve
stated goals and objectives and respond to
changes in the field (See Funding Section IV5
for flexibility language related to use of funds)
Flexibility language includes using staff time and
funds for
a) Sharing positions (eg the State HDSP and
Nutrition Program sharing the costs of a policy
analyst)
b) Conducting training activities (eg program
funding staff and partners on common
skills such as program evaluation ways to
reduce disparities use of data for program
planning or use of policy and systems change
strategies)
c) Planning (eg joint planning on how to address
disparities programs jointly plan a state public
health conference that addresses common skills
and specific program-related sessions)
Action Framework for a Comprehensive Public Health Strategy to Prevent Heart Disease and Stroke
Social and environmental conditions favorable to health
Behavioral patterns that promote health
Low population risk
Few events only rare deaths
Full functional capacitylow risk of recurrence
Good quality of life until death
National action plan overarching goal To increase quality and years of healthy life and to eliminate disparities
A vision of the future
Goal 1 Goal 2 Goal 3 Goal 4 Prevent the development Detect and treat risk factors Early identification and treatment Prevent recurrence and
of risk factors for for heart disease and stroke of heart disease and stroke complications of heart disease and stroke heart disease an stroke
Roles of states
Prevent the development of risk factors for
heart disease and stroke
bull Control high blood pressure
bull Control high cholesterol
bull Increase awareness of signs and symptoms
bull Improve emergency response
bull Improve quality of care
bull Eliminate disparities
DIRECT PROGRAM ROLE SUPPORTIVE ROLE
22
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
23
d) Developing procedures and formats that
increase understanding across programs (eg
consistent formats for documents such as state
plans and descriptions of burden)
bull State health departments should determine how
best to facilitate coordination and cooperation
among existing categorical program efforts while
allowing each program to maintain individual
integrity and identity
bull States should utilize tools including the Partners
for Prevention document Comprehensive and
Integrated Chronic Disease Prevention Action
Planning Handbook for States and Communities
(at wwwpreventorg) which contains activities to
help state programs identify areas of collaboration
for mutual benefit increase efficiency and better
serve the people of the state
Section 3 Performance Measures by Funding Designation
Capacity Building Performance Measures
At the time of application states applying for funding
may have already achieved various performance
measures for capacity building States should review
the following measures identify those already
achieved and plan to address the remaining
performance measures within the first 1 to 2 years
of funding
Annually
bull Collaborate with state health department partners
on the planning and implementation of at least
one capacity-building activity or state heart disease
and stroke prevention plan activity
bull Leverage resources from external partners to
facilitate the development or implementation of
the state heart disease and stroke prevention plan
Provide two narrative examples
By the end of year 1
bull Employ one full-time project manager
bull Employ one half-time chronic disease
epidemiologist
bull Develop a heart disease and stroke burden profile
for program planning and training
bull Establish a state partnership comprising diverse
partners
bull Develop a plan for convening and maintaining a
state partnership
bull Convene one partnership meeting toward the
development of a state plan
By the end of year 2
bull Complete a training needs assessment Develop
and implement a training plan to increase the
capacity of staff and partners
bull Publish in hard copy a state heart disease and
stroke burden report
By the end of year 3
bull Publish in hard copy a comprehensive state plan
that uses burden and assessment findings addresses
prevention of heart disease and stroke addresses
heart disease and stroke risk factors proposes
policy and systems changes as approaches to the
six priority areas identifies how progress toward
successful achievement of the plan will be evaluated
and documents partner involvement in planning and
implementing the state plan
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
24
bull Complete an evaluation of the state partnership
including for example partner satisfaction
commitment and involvement infrastructure
and functioning effectiveness and outcomes
and sustainability
bull Develop an approach to implementing the state
plan as part of the program work plan
By the end of year 4
bull Implement the state plan in collaboration with
partners using policy and systems change to
address the six State HDSP Program priority areas
bull Develop an implementation plan for at least
two population-based policy or systems change
interventions in one or more of the State HDSP
Program priority areas in collaboration with
partners
By the end of 5 years
bull Implement and initiate evaluation of a small-scale
version of at least one of the population-based
interventions proposed in year 4
bull Update the burden profile
bull Meet all criteria for requesting basic
implementation funds and apply for basic
implementation funding
Basic Implementation Program Performance Measures
Annually
bull Demonstrate progress toward achieving goals
of the comprehensive state plan in collaboration
with partners
bull Assure the state burden document has been
published within the previous 5 years
bull Collaborate with state health department partners
on the implementation of at least one state heart
disease and stroke prevention plan activity
bull Collaborate with state health department partners
on the implementation of at least one activity
related to priority areas 1ndash6
bull Leverage resources from external partners to
implement at least one state heart disease and
stroke prevention plan activity Provide a narrative
example
bull Leverage resources from external partners to
implement at least one intervention activity related
to priority areas 1ndash6 Provide a narrative example
By the end of year 1
bull Maintain one full-time project manager
bull Maintain one half-time chronic disease
epidemiologist
bull Provide for one half-time evaluator or equivalent
bull Complete a training needs assessment of staff and
partners Develop and implement a training plan
based on needs assessment
bull Update as needed a state heart disease and stroke
burden profile for program planning
By the end of year 2
bull Implement and initiate evaluation of at least
two population-based policysystem change
interventions to control high blood pressure and
or high blood cholesterol in the health care or
worksite setting This should include consideration
of Priority Populations
bull Evaluate the state partnership Include an
evaluation of the effectiveness of the partnership
in leveraging resources and implementing
interventions
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
25
By the end of year 3 policy and systems changes and contributions of
bull Implement and initiate evaluation of at least one
additional population-based policysystems change
intervention strategy in one of the remaining
program priority areas (quality of care [other
than high blood pressure or high cholesterol]
emergency response signs and symptoms in
the health care or worksite setting) This should
include consideration of Priority Populations
bull Update state heart disease and stroke burden
profile
bull Document contributions of partners (leveraged
resources) to implementing priority area policy
and system change interventions
By the end of year 4
bull Document continued progress on implementing
and evaluating population-based interventions
using the MIS
bull As applicable evaluate interventions among
Priority Populations
bull Use evaluation findings for program improvement
Submit a brief summary of intervention evaluation
findings that includes an improvement plan
By the end of the year 5
bull Expand existing or implement new population-
based policysystems change interventions in the
program priority areas As applicable evaluate
interventions among Priority Populations
bull Update state heart disease and stroke burden
profile
bull Complete an executive summary of program
accomplishments that covers the funding cycle
including policy and systems changes impact of
the partners (leveraged resources) to implementing
priority area policy and systems change
interventions
Capacity Building Performance Measures for Optional Funding
Includes evidence that the applicant has built
significant capacity as specified in the Capacity
Building Program Activities 1ndash4
1 Evidence of a management plan that describes
a) program staffing and qualifications in terms
of requirements in the program announcement
and b) methods of communication between state
health department programs that relate to heart
disease and stroke prevention including program
priority areas 1ndash6
2 Evidence of at least 10 diverse and active
partners that include partners from state health
department programs other state agencies
organizations that promote cardiovascular
health or address heart disease and stroke or
related risk factors organizations that improve
health and organizations that provide access to
populations (including Priority Populations) or
settings (including health care and worksites) by
provision of documentation such as memoranda
of understanding or other letters of agreements
summaries of meetings that delineate partnersrsquo
leadership for completing tasks outcomes or
products of the partnership and other documents
that demonstrate collaboration on HDSP program
activities with partners
3 Evidence that a heart disease and stroke burden
document has been published by provision of a
burden document (published in the past 3 years)
that describes the burden of heart disease and
stroke and related risk factors geographic and
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
26
demographic distribution of heart disease and bull Develop an evaluation strategy that will be used
stroke including racial and ethnic disparities and to assess the selected activities
trends in heart disease and strokeBy the end of Project Year 3
4 Evidence of a draft heart disease and stroke
prevention state plan developed with the input
of partners from within and external to the state
health department evidence of a process for
finalizing publishing and implementing the plan
Stroke Network Performance Measures
By the end of Project Year 1
bull Hire a project coordinator
bull Convene a stroke network structure that may be
composed of an advisory group with supporting
work groups and committees
bull Demonstrate evidence of diverse partnerships with
key stakeholders across member states and the
region
bull Develop a documentpublication describing
regional stroke burden risk factors and geographic
and demographic distribution of stroke
bull Develop a strategic plan with timelines that
describes policy and systems change strategies
that will be implemented in years 2 and 3
By the end of Project Year 2
bull Utilize the strategic plan timeline burden data
and other assessment data (eg of policies
systems of care) to develop a stroke regional
plan that defines goals objectives priorities and
policy and systems approaches and describes
participation and commitment by partners across
the region and within member states
bull Prioritize and select policy- and systems-level
activities that will be implemented in a
coordinated and uniform fashion across
the region
bull Provide evidence of the implementation of
uniform policy and systems change activities
across the region
bull Demonstrate the effectiveness of stroke network
structure and partnerships
bull Utilize network data to engage stakeholders in
promoting policy and systems change activities
Promote stroke network accomplishments
through such means as reports journal articles
presentations best practices a website etc
bull Evaluate stroke network impact on the regional
stroke burden statewide or organizational policies
or policy and decision makers
bull Enhance stroke network partnership and leverage
resources to ensure sustainability of activities
Section 4 Reporting Requirements The applicant must provide CDC with the following
reports
1 Interim progress report due March 12 The
progress report will serve as the non-competing
continuation application and must contain the
following elements
a) Current Budget Period ActivitiesObjectives
Progress
b) Current Budget Period Financial Progress
c) New Budget Period Program Proposed
Activities and Objectives
d) Budget
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
27
e) Measures of Effectiveness
f) Additional Requested Information
The Interim Progress Report should be submitted using the HDSP MIS
2 Financial status report and annual progress report
due no more than 90 days after the end of the
budget period
3 Annual progress report should be submitted using
the CDC Heart Disease and Stroke Prevention
MIS It should report on activities for the year of
funding
4 Final performance and Financial Status reports
due no more than 90 days after the end of the
project period
The reports must be mailed to the Grants
Management Specialist listed in the programrsquos
Notice of Award
Section 5 Budget Guidance and Funding Restrictions Restrictions which must be taken into account while
writing the budget are as follows
bull Funds may not be used for research
bull Reimbursement of pre-award costs is not allowed
bull Funds may not be used to supplant state or
local funds
bull Funds may not be used for construction
bull Funds may not be used to provide health
screening patient care personal health services
medications patient rehabilitation or other costs
associated with the treatment of heart disease
or stroke
bull Awardees may not generally use HHSCDC
ATSDR funding for the purchase of furniture or
equipment Any such proposed spending must
be identified in the budget
bull The direct and primary recipient in a cooperative
agreement program must perform a substantial
role in carrying out project objectives and not
merely serve as a conduit for an award to another
party or provider who is ineligible
Guidance for completing the budget can be found on
the CDC website at wwwcdcgovodpgofunding
budgetguidehtm
As part of the increased flexibility efforts applicants
are encouraged to maximize the public health benefit
from the use of CDC funding within the approved
budget line items and to enhance the granteersquos
ability to achieve stated goals and objectives and to
respond to changes in the field as they occur within
the scope of the award Recipients also can redirect
up to 25 percent of the total approved budget or
$250000 whichever is less to achieve stated goals
and objectives within the scope of the award except
from categories that require prior approval such
as contracts change in scope and change in key
personnel A list of required prior approval actions
is included in the Notice of Grant Award
Section 6 Administrative and National Policy Requirements Successful applicants must comply with the
administrative requirements outlined in 45 CFR
Part 74 and Part 92 as appropriate The following
additional requirements apply to this project
bull AR-8 Public Health System Reporting
Requirements
bull AR-9 Paperwork Reduction Act Requirements
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
28
bull AR-10 Smoke-Free Workplace Requirements
bull AR-11 Healthy People 2010
bull AR-12 Lobbying Restrictions
bull AR-14 Accounting System Requirements
bull AR-23 States and Faith-Based Organizations
bull AR-24 Health Insurance Portability and
Accountability Act Requirements
bull AR-25 Release and Sharing of Data
bull AR-27 Conference Disclaimer and Use of Logos
Additional information on the requirements can be
found on the CDC website at wwwcdcgovodpgo
fundingAddtl_Reqmntshtm
For more information on the Code of Federal
Regulations see the National Archives and Records
Administration at wwwgpoaccessgovcfrindexhtml
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Management Information System (MIS) At-A-Glance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
30
About the Heart Disease and Stroke Prevention Management Information System (HDSP MIS) The HDSP MIS is a reporting system that allows
each funded Heart Disease and Stroke Prevention
Program to document information relevant to its
program such as the statersquos work plan and evaluation
measures track the progress of its program and
create and submit required progress reports to CDC
The HDSP MIS supports funded state Heart Disease
and Stroke Prevention Programs in the following
ways
bull Enables states to describe their program activities
and expected use of CDC funds for heart disease
and stroke prevention
bull Enables CDC to track progress on state program
activities and identify promising practices
bull Reduces both the statesrsquo and CDCrsquos burden
of program planning reporting and overall
administration
bull Assists CDC in identifying the need for training
and technical assistance
bull Standardizes the state reporting process to
facilitate evaluation
bull Enables CDC to answer requests for information
more quickly and improve sharing of lessons
learned among states
Access to HDSP MIS To access the HDSP MIS follow the steps below
1 Open your Internet Web browser (ie Internet
Explorer Netscape) by clicking on the desktop
icon or by clicking the Start button selecting
ldquoProgramsrdquo and clicking the button for your
browser
2 In the Web browser type in the Web address
httpappsnccdcdcgovhdspmis and press the
Enter key The HDSP login screen is displayed
Recommendation If you have not already done
so you might want to bookmark the HDSP
MIS website (or make it a favorite) on your Web
browser so you wonrsquot have to type in the URL the
next time you want to access it
3 On the login screen enter your assigned user ID
and password and click ldquologinrdquo If you enter your
user ID or password incorrectly three times you
will be locked out of the system for approximately
1 hour
The HDSP MIS home screen is displayed
For new HDSP-funded staff members To request
access to MIS (HDSP-funded staff only) please e-mail
Shanda Blue at sbluecdcgov The e-mail request
should include the program staff personrsquos full name
phone number and e-mail address
MIS Help Manual Access Information A help manual is available to assist HDSP-funded
programs with navigating the HDSP MIS To access
the help manual first log on to the MIS Then
complete the following steps
1 Click on the word ldquohelprdquo in the right-hand corner
2 Click ldquoshow navigation panerdquo
3 Once the navigation pane is shown click on
ldquotraining manualrdquo to access the manual
4 The manual is a PDF document that can be
printed in its entirety or by chapter
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
31
MISProgrammatic Information Contacts For support regarding use of the HDSP MIS
guidance on the type of information that should
be documented in the HDSP MIS or technical
issues HDSP staff should contact the Project Officer
assigned to their program
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Guidelines for Budget Preparation
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Introduction Guidance is offered for the preparation of a budget request Following this guidance will facilitate the review
and approval of a requested budget by insuring that the required or needed information is provided
A Salaries and Wages
For each requested position provide the following information name of staff member occupying the position
if available annual salary percentage of time budgeted for this program total months of salary budgeted and
total salary requested Also provide a justification and describe the scope of responsibility for each position
relating it to the accomplishment of program objectives
sample Budget
Personnel Total $____________
Position Title and Name Annual Time Months Amount Requested
Project Coordinator susan taylor
$45000 100 12 months $45000
finance administrator John Johnson
$28500 50 12 months $14250
outreach supervisor $27000 100 12 months $27000(vacant)
sample Justification The format may vary but the description of responsibilities should be directly related to specific program
objectives
Job Description Project Coordinatormdash(Name)
this position directs the overall operation of the project is responsible for overseeing the implementation of project activities coordination with other agencies development of materials provisions of in service and training and conducting meetings designs and directs the gathering tabulating and interpreting of required data is responsible for overall program evaluation and for staff performance evaluation and is the responsible authority for ensuring necessary reportsdocumentation are submitted to CDC this position relates to all program objectives
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
33
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
B Fringe Benefits
Fringe benefits are usually applicable to direct salaries and wages Provide information on the rate of fringe
benefits used and the basis for their calculation If a fringe benefit rate is not used itemize how the fringe
benefit amount is computed
sample Budget
Fringe Benefits Total $___________
25 of total salaries = fringe Benefits
if fringe benefits are not computed by using a percentage of salaries itemize how the amount is determined
example Project Coordinator ndash salary $45000
retirement 5 of $45000 = $2250 fiCa 765 of $45000 = $3443 insurance = $2000 Workersrsquo Compensation = ______
total
C Consultant Costs
This category is appropriate when hiring an individual to give professional advice or services (eg training
expert consultant etc) for a fee but not as an employee of the grantee organization Written approval must
be obtained from CDC prior to establishing a written agreement for consultant services Approval to initiate
program activities through the services of a consultant requires submission of the following information to
CDC (see Other Information)
1 Name of consultant
2 Organizational affiliation (if applicable)
3 Nature of services to be rendered
4 Relevance of service to the project
5 Number of days of consultation (basis for fee) and
6 Expected rate of compensation (travel per diem other related expenses)mdashlist a subtotal for each
consultant in this category
If the above information is unknown for any consultant at the time the application is submitted the information
may be submitted at a later date as a revision to the budget In the body of the budget request a summary
should be provided of the proposed consultants and amounts for each
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
34
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
D Equipment
Provide justification for the use of each item and relate it to specific program objectives Maintenance or rental
fees for equipment should be shown in the Other category
sample Budget
Equipment Total $_______
Item Requested How Many Unit Cost Amount Computer Workstation 2 ea $ 5500 $ 11000 Computer 1 ea $ 6000 $ 6000
total $ 17000
sample Justification Provide complete justification for all requested equipment including a description of how it will be used in
the program
Note Equipmentmdashtangible non-expendable personal property (including exempt property) charged directly to an award having a useful life of more than 1 year aND an acquisition cost of $5000 or more per unit However consistent with recipient policy a lower threshold may be established Please provide the information to the grants management officer to establish a lower equipment threshold to reflect your organizationrsquos policy
E Supplies
Individually list each item requested Show the unit cost of each item number needed and total amount
Provide justification for each item and relate it to specific program objectives If appropriate General Office
Supplies may be shown by an estimated amount per month times the number of months in the Budget category
sample Budget
Supplies Total $_______
Computer workstation (specify type) 3 ea x $2500 = $ 7500 Computer (specify type) 2 ea x $3300 = $ 6600 general office supplies (pens pencils paper etc) 12 months x $240year x 10 staff = $ 2400educational pamphlets (3000 copies $1 each) = $ 3000 educational videos (10 copies $150 each) = $ 1500 Word processing software ( $400mdashspecify type) = $ 400
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
35
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
______
Travel (in-state and out-of-state) Total $_______
In-State Travel 1 trip x 2 people x 500 miles rt x $27mile = $ 270 2 days per diem x $37day x 2 people = $ 148 1 nightrsquos lodging x $67night x 2 people = $ 134 25 trips x 1 person x 300 miles avg x $27mile = $ 2025
total $ 2577
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Justification Provide complete justification for all requested supplies including a description of how it will be used in the
program
general office supplies will be used by staff members to carry out daily activities of the program the education pamphlets and videos will be purchased from XXX and used to illustrate and promote safe and healthy activities Word processing software will be used to document program activities process progress reports etc
F Travel
Dollars requested in the Travel category should be for staff travel only Travel for consultants should be
shown in the Consultant category Travel for other participants advisory committees review panel etc
should be itemized in the same way specified below and placed in the Other category
In-State TravelmdashProvide a narrative justification describing the travel staff members will perform List
where travel will be undertaken number of trips planned who will be making the trip and approximate
dates If mileage is to be paid provide the number of miles and the cost per mile If travel is by air provide
the estimated cost of airfare If per diemlodging is to be paid indicate the number of days and amount of
daily per diem as well as the number of nights and estimated cost of lodging Include the cost of ground
transportation when applicable
Out-of-State TravelmdashProvide a narrative justification describing the same information requested above
Include CDC meetings conferences and workshops if required by CDC Itemize out-of-state travel in the
format described above
sample Budget
sample Justification the Project Coordinator and the outreach supervisor will travel to (location) to attend aiDs conference the Project Coordinator will make an estimated 25 trips to local outreach sites to monitor program implementation
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
36
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
______
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
sample Budget
Out-of-State Travel 1 trip x 1 person x $500 rt airfare = $ 5003 days per diem x $45day x 1 person = $ 1351 nightrsquos lodging x $88night x 1 person = $ 88ground transportation 1 person = $ 50
total $ 773
sample Justification the Project Coordinator will travel to CDC in atlanta ga to attend the CDC Conference
G Other
This category contains items not included in the previous budget categories Individually list each item
requested and provide appropriate justification related to the program objectives
sample Budget
Other Total $_______
telephone ($____ per month x ____ months x staff) = $ subtotal Postage ($____ per month x ____ months x staff) = $ subtotalPrinting ($____ per x ____ documents) = $ subtotal equipment rental (describe) ($____ per month x ____ months) = $ subtotalinternet Provider service ($____ per month x ____ months) = $ subtotal
sample Justification Some items are self-explanatory (telephone postage rent) unless the unit rate or total amount requested is
excessive If not include additional justification For printing costs identify the types and number of copies of
documents to be printed (eg procedure manuals annual reports materials for media campaign)
H Contractual Costs
Cooperative Agreement recipients must obtain written approval from CDC prior to establishing a third-
party contract to perform program activities Approval to initiate program activities through the services of a
contractor requires submission of the following information to CDC (see Other Information)
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
37
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
1 Name of contractor
2 Method of selection
3 Period of performance
4 Scope of work
5 Method of accountability and
6 Itemized budget and justification
If the above information is unknown for any contractor at the time the application is submitted the
information may be submitted at a later date as a revision to the budget Copies of the actual contracts should
not be sent to CDC unless specifically requested In the body of the budget request a summary should be
provided of the proposed contracts and amounts for each
I Total Direct Costs $__________
Show total direct costs by listing totals of each category
J Indirect Costs $__________
To claim indirect costs the applicant organization must have a current approved indirect cost rate agreement
established with the cognizant federal agency A copy of the most recent indirect cost rate agreement must be
provided with the application
sample Budget
The rate is ___ and is computed on the following direct cost base of $__________
Personnel $____________ fringe $____________ travel $____________ supplies $____________ other $____________ total $____________ x ___ = total indirect Cost
If the applicant organization does not have an approved indirect cost rate agreement costs normally identified
as indirect costs (overhead costs) can be budgeted and identified as direct costs
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
38
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Other Information
Required Information for Consultant Approval
This category is appropriate when hiring an individual who gives professional advice or provides services for
a fee and who is not an employee of the grantee organization All consultants require prior approval from
CDC annually Submit the following required information for consultants
1 Name of Consultant Identify the name of the consultant and describe his or her qualifications
2 Organizational Affiliation Identify the organization affiliation of the consultant if applicable
3 Nature of Services To Be Rendered Describe in outcome terms the consultation to be provided
including the specific tasks to be completed and specific deliverables A copy of the actual consultant
agreement should not be sent to CDC
4 Relevance of Service to the Project Describe how the consultant services relate to the accomplishment
of specific program objectives
5 Number of Days of Consultation Specify the total number of days of consultation
6 Expected Rate of Compensation Specify the rate of compensation for the consultant (eg rate per hour
rate per day) Include a budget showing other costs such as travel per diem and supplies
7 Method of Accountability Describe how the progress and performance of the consultant will be
monitored Identify who is responsible for supervising the consultant agreement
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
39
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Required Information for Contract Approval
All contracts require prior approval from CDC Funds may not be used until the following required
information for each contract is submitted to and approved by CDC
1 Name of Contractor Who is the contractor Identify the name of the proposed contractor and indicate
whether the contract is with an institution or organization
2 Method of Selection How was the contractor selected State whether the contract is sole source or
competitive bid If an organization is the sole source for the contract include an explanation as to why
this institution is the only one able to perform contract services
3 Period of Performance How long is the contract period Specify the beginning and ending dates of the
contract
4 Scope of Work What will the contractor do Describe in outcome terms the specific servicestasks to
be performed by the contractor as related to the accomplishment of program objectives Deliverables
should be clearly defined
5 Method of Accountability How will the contractor be monitored Describe how the progress and
performance of the contractor will be monitored during and on close of the contract period Identify
who will be responsible for supervising the contract
6 Itemized Budget and Justification Provide an itemized budget with appropriate justification If
applicable include any indirect cost paid under the contract and the indirect cost rate used
Source CDCProcurements and Grants Office httpwwwcdcgovodpgofundinggrantsBudget_Guidelinesdoc
40
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Program Evaluation Guidance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
42
Introduction The Evaluation and Program Effectiveness Team
(EPET) is part of the Applied Research and
Evaluation Branch of CDCrsquos Division for Heart
Disease and Stroke Prevention (DHDSP) EPET
members are assigned to funded state programs and
provide a range of evaluation technical assistance
activities EPET looks forward to working with you
on your state evaluation activities
The goals of EPET are to
1 Provide timely evaluation technical assistance to
CDC-funded state health departments as they
undertake required evaluation tasks
2 Promote and support the use of appropriate
evaluation methods to improve program
effectiveness
This Welcome Packet provides important information
about DHDSP and the evaluation technical assistance
offered to states The packet includes
bull An overview of the National Heart Disease and
Stroke Prevention (HDSP) Program
bull Evaluation requirements of the current funding
opportunity announcement (FOA)
bull A list of current evaluation technical assistance
available to state programs
bull A list of resources that can help you plan and
implement your program evaluation activities
As you begin evaluation work with your state
program EPET is available to assist you A list of
EPET members assigned to states is included in
this packet so that you can become familiar with
your EPET evaluation contact EPET will work in
collaboration with your statersquos assigned project
officer to address your evaluation needs
Section 1 Announcement DP07-704 Evaluation Performance Measures Announcement DP07-704 contains several
requirements for evaluation Performance measures
for each year are listed in the FOA All states are
expected to engage in evaluation of their programs
At a minimum all basic implementation (BI) states
are expected to develop programmatic logic models
and evaluation plans for at least one intervention or
project States also are expected to report program
progress in the HDSP Management Information
System (MIS)
The next two pages contain lists of performance
measures that are specific to evaluation and their
respective time frames for capacity building (CB)
and BI HDSP programs
Section 2 The EPET Evaluation Technical Assistance Services
Evaluation Assistance Available to State Programs
EPET provides evaluation assistance to states through
trainings quarterly evaluation conference calls one-
on-one calls with states an annual review of state
evaluation activities participation in site visits and
ad-hoc evaluation technical assistance Each of these
EPET services will be briefly reviewed
Trainings
EPET in partnership with evaluation experts and
contractors offers a variety of evaluation training
sessions as a part of the annual grantee meeting
EPET strives to deliver trainings that are relevant
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
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46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
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47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
Performance Measures Specific to Evaluation Capacity Building and Basic Implementation Programs
Evaluation Activity Capacity Building
Basic Implementation
Designate Evaluation Staff 5 fte or equivalent X
Logic Model Develop an overall program logic model that graphically describes the relationship between program activities and expected outcomes and reflects program priorities (see the HDsP evaluation guide logic models)
X X
Develop an Overall Evaluation Plan the evaluation plan should include process and outcome evaluation to assess effectiveness and potential impact of the interventionproject (Bi) or partnership (CB)
X X
Use of the Management Information System (MIS) use the HDsP mis to track progress toward achieving HDsP work plan objectives X X
Core Indicators report on comprehensive and core indicators as they become available X X
By the end of Year 1
Complete a training needs assessment of staff and partners Develop and implement a training plan based on the needs assessment X
By the end of Year 2
Complete a training needs assessment Develop and implement a training plan to increase the capacity of staff and partners X
implement and initiate evaluation of at least two population-based policysystems change interventions to control high blood pressure andor high blood cholesterol in the health care or worksite setting Priority Populations should be considered
X
evaluate the state partnership including its effectiveness in leveraging resources and implementing interventions X
By the end of Year 3
evaluate the state partnership including for example partner satisfaction commitment and involvement infrastructure and functioning effectiveness and outcomes and sustainability
X
implement and initiate evaluation of at least one additional population-based policy systems change intervention strategy in one of the remaining program priority areas (quality of care [other than high blood pressure or high cholesterol] emergency response signs and symptoms in the health care or worksite setting)
X
By the end of Year 4
Document continued progress on implementing and evaluating population-based interventions using the mis X
evaluate interventions among Priority Populations and use evaluation findings for program improvement submit a brief summary of intervention evaluation findings that includes an improvement plan
X
By the end of Year 5
implement and initiate evaluation of a small-scale version of at least one of the population-based interventions proposed in year 4 X
evaluate interventions among Priority Populations X
43
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
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46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
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48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
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44
timely and useful Examples of evaluation trainings
that EPET has offered in the past include
bull Strengthening and evaluating state partnerships
bull Developing logic models
bull Economic evaluation
bull Using evaluation indicators
bull Questionnaire and survey design
bull The intersection between epidemiology and
evaluation
bull Developing an evaluation plan
bull Needs assessment using qualitative data collection
methods
bull Software tools for program evaluation
bull Evaluation strategies for media campaigns
Quarterly Evaluation Conference Calls
In partnership with the Program Services Team EPET
offers quarterly telephone conference calls focused
on evaluation topics These calls often address
upcoming evaluation requirements of the cooperative
agreement The list of calls is sent annually
Scheduled One-on-One Calls with States
EPET participates in a variety of one-on-one calls
with states including
bull Introductory evaluation call during monthly
project officer call This call includes a 15-minute
introduction to your EPET primary evaluation contact
and a brief explanation of the evaluation technical
assistance that will be provided for your state
bull Evaluation-specific technical assistance during
monthly project officer call Project officers and
EPET staff will work together to connect you
to the EPET staff person assigned to your state
(see Appendix B for EPET staff assignments) and
further explain evaluation measures and available
evaluation technical assistance and trainings In
addition time will be allocated during the monthly
calls to discuss program evaluationndashrelated areas at
least once a year
Evaluation Activity
By the end of Year 2
Develop an evaluation strategy that will be used to assess the selected activities
By the end of Year 3
bull Provide evidence of the implementation of uniform policy and systems change activities across the region
bull Demonstrate the effectiveness of stroke network structure and partnerships
bull Use network data to engage stakeholders in promoting policy and systems change activities Promote stroke network accomplishments through such means as reports journal articles presentations best practices and websites
bull Evaluate stroke network impact on the regional stroke burden statewide or organizational policies or policy and decision makers
Performance Measures Specific to Evaluation Stroke Network Programs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
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46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
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47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
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49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
45
Annual Review of State Evaluation Activities
EPET staff conduct a thorough annual review of each
BI statersquos evaluation plan logic model MIS data
evaluation reports and other relevant information
related to its evaluation efforts Findings are
discussed with the CDC project officer and states are
provided with written feedback from the assessment
including recommendations and follow-up steps
Participation in Site Visits
At the request of a project officer or state staff BI and
CB Optional states can have their assigned EPET staff
person join their project officer on a site visit Time
will be set aside on the site visit agenda for the EPET
staff to provide technical assistance for interventions
evaluated by the state
Alternatively for any state (BI CB Optional or CB)
the assigned EPET staff person can participate in any
portion(s) of the site visit pertaining to evaluation
(eg update of evaluation activities evaluation
questions or concerns) via phone EPET staff
appreciate the opportunity to participate in site visits
via phone to stay updated about the statersquos evaluation
activities
Ad Hoc Evaluation Technical Assistance
EPET can provide evaluation technical assistance
to states on an as-needed basis Consultation is
available for multiple evaluation topics and activities
For example states can access individual technical
assistance for help with
bull Designing an evaluation (where to start what to
evaluate)
bull Deciding who to engage in evaluation activities
(identifying evaluation stakeholders and intended
users)
bull Developing and prioritizing evaluation questions
bull Reviewing a state logic model or evaluation plan
bull Developing an evaluation protocol
bull Collecting and analyzing data
bull Determining ways to ensure use of evaluation
results and share lessons learned
bull Conducting economic evaluations
How to Access Technical Assistance from EPET
Each state has been assigned EPET staff members
Your assigned EPET staff members will provide
your state with evaluation technical assistance as
needed Appendix B provides state assignments
for evaluation As shown each state is assigned a
primary and secondary evaluation contact The two
evaluation contacts work together to ensure that
statesrsquo evaluation needs are met A statersquos primary
point of contact for evaluation technical assistance is
listed as the ldquoevaluation contactrdquo
Requests for technical assistance from EPET should
include your project officer Evaluation technical
assistance can be accessed during the monthly calls
with your project officer In addition EPET staff can
be contacted via e-mail Contact information for
EPET staff is listed on the next page Please copy your project officer on any e-mails you send to your assigned EPET staff member
In addition to keeping your project officer informed
of your contact with EPET staff it is important to
communicate this information to your state program
manager
Please remember to copy your project officer when
contacting your assigned EPET staff person for
evaluation technical assistance
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
46
Section 3 Evaluation Competencies for State HDSP Evaluators
State evaluators are expected to perform a range of
evaluation activities for their programs Evaluation
requirements are noted in FOA 704 and in the list of
performance measures specific to evaluation
An evaluation competencies checklist was developed
to help evaluators identify and build requisite skills
The checklist is for state HDSP program reference
only and includes recommended competencies for
state evaluators It can be used to determine the
DHDSP Evaluation Competencies Checklist
Evaluation Approach
Apply the CDC framework for program evaluation to evaluation projects
bull Apply professional standards of feasibility utility accuracy and propriety to evaluation work
Apply evaluation theory and models to evaluate
bull Chronic disease prevention and control
bull Policy and system change
Gather evidence through a review of scientific and other literature
Evaluability Assessment
Assess the readiness of an intervention or program to undergo a formal evaluation
Examine the stage of development of a program or strategy
Assess a programrsquos capacity to collect evaluation data
Assess the level of rigor needed to begin an evaluation study
Identify the potential uses of results of a formal evaluation
range of evaluation skills needed and to identify
areas for improvement
Remember if you need assistance your project
officers and assigned EPET staff are available This
checklist can help you identify areas for which you
may want to access technical assistance
Evaluation Competencies
The evaluator competencies checklist on the
following pages is a list of specific evaluation skills
that reflects DHDSP evaluation activities This list of
competencies is intended for state program staff who
carry out evaluation activities
Cultural Competence
Gain experience conducting evaluations in a variety of cultural settings
Apply principles of cultural appropriateness to evaluation design methods and procedures
Interpersonal Communication Skills
Communicate effectively using verbal and listening skills
Communicate with local state and national HDSP partners in the evaluation process
Logic Modeling
Develop a clear understanding of the programrsquos purpose and objective
Articulate a program theory of change by displaying the key relationships among inputs activities outputs and outcomes in a logic model
Ensure that an appropriate level of detail is included
Use a logic model for evaluation planning
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
47
DHDSP Evaluation Competencies Checklist (continued)
Developing an Evaluation Plan
Frame evaluation questions to reflect program and stakeholder needs
Write SMART objectives (ie 1 Specific 2 Measurable 3 Achievable 4 Realistic 5 Time-limited)
Link evaluation questions to appropriate evaluation designs
Conducting Process Evaluation
Describe assess monitor and track components of the program using process indicators
Articulate how and why a program operates
Use information about inputs activities and outputs to support program improvement
Conducting Outcome Evaluation
Determine indicators to measure program success
Monitor program performance
Collecting Analyzing and Interpreting Evaluation Data
Identify and appropriately use public health data as an evaluation tool
Apply appropriate data collection methods for measuring intended evaluation questions
Collect and analyze qualitative data using appropriate methods
Collect and analyze quantitative data using basic statistical methods
Use statistical software such as SPSS SAS Excel and Access to analyze program and evaluation data
Synthesize findings across evaluations
Evaluating State Partnerships
Develop a detailed evaluation plan for evaluating state partnerships
Design and implement a training needs assessment
Evaluation Reporting
Design appropriate evaluation communication strategies for intended audiences
Prepare a written report for varied internal and external audiencespartners
Prepare oral presentations for varied internal and external audiencespartners
Arrange or facilitate learning sessions and documents regarding evaluation results
Evaluation Utilization
Assess the feasibility of the evaluation recommendations
Ensure evaluation data are used in an ongoing way to inform program and evaluation planning
Link the evaluation to decision making
Maximize evaluation utility
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
48
Section 4 Evaluation Resources Resources are available to assist with the evaluation
of state programs A series of evaluation guidance
documents from DHDSP and a number of additional
resources can help states conduct required evaluation
activities This chapter provides a list of useful
evaluation resources
Evaluation Guidance Documents
EPET has developed a series of evaluation guidance
documents intended to aid skill building on a wide
range of general evaluation topics and selected
specific topics The documents were developed with
the assumption that state health departments have
varied experience with program evaluation and a
range of resources allocated to program evaluation
These guides clarify approaches to and methods
for evaluation provide examples specific to the
scope and purpose of state HDSP programs and
recommend resources for additional reading Guides
have been developed for the following topics
bull Writing SMART objectives
bull Developing and using a logic model
bull Developing an evaluation plan
bull Evaluating partnerships
The guides are available online at wwwcdcgov
DHDSPstate_programevaluation_guidesindexhtm
States can learn more about DHDSP by visiting
wwwcdcgovDHDSPindexhtm
Additional Evaluation Resources
The following resource list is divided by topic and
includes links to valuable information from CDC and
other national organizations
general evaluation sites These sites provide a variety of evaluation tools
techniques and resources
CDC Evaluation Working Group
wwwcdcgoveval
University of Wisconsin - Extension Program
Development and Evaluation
wwwuwexeducespdande
Western Michigan University Evaluation Center
wwwwmicheduevalctr
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
evaluation theorymodelapproach CDCrsquos Framework for Program Evaluation in Public
Health
wwwcdcgovevalframeworkhtm
CDC State Heart Disease and Stroke Prevention
Program Evaluation Framework
wwwcdcgovDHDSPlibraryevaluation_framework
indexhtm
evaluability assessment Wholey JS Evaluability assessment In Wholey JS
Hatry HP Newcomer KE editors Handbook of
practical program evaluation 2nd ed San Francisco
Jossey-Bass 2004 p 33ndash61
Thurston WE Potvin L Evaluability assessment A
tool for incorporating evaluation in social change
programmes Evaluation 20039(4)453ndash469
Cultural Competence Hood S Hopson R Frierson H editors The role
of culture and cultural context A mandate for
inclusion the discovery of truth and understanding
in evaluative theory and practice Greenwich CT
Information Age Publishing 2005
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
49
logic models DHDSP Evaluation Guide Developing and Using a
Logic Model
wwwcdcgovDHDSPstate_programevaluation_
guidespdfslogic_modelpdf
WK Kellogg Foundation Logic Model Development
Guide
httpwwwwkkforgknowledge-center
resources2010Logic-Model-Development-Guideaspx
smart objectives DHDSP Evaluation Guide Writing SMART Objectives
wwwcdcgovDHDSPstate_programevaluation_
guidessmart_objectiveshtm
Conducting evaluations Introduction of Process Evaluation in Tobacco Use
Prevention and Control
wwwcdcgovTobaccotobacco_control_programs
surveillance_evaluationprocess_evaluation
indexhtm
WK Kellogg Foundation Evaluation Handbook
httpwwwwkkforgknowledge-center
resources2010W-K-Kellogg-Foundation-Evaluationshy
Handbookaspx
NSF User-Friendly Handbook for Project Evaluation
wwwnsfgovpubs2002nsf02057starthtm
Data Collection analysis and interpretation Taylor-Powell E Steele S Collecting evaluation data
An overview of sources and methods Madison WI
University of Wisconsin Extension 1996 Available
from URL httplearningstoreuwexedupdf
G3658-4pdf
Strauss A Corbin J Basics of qualitative research
Techniques and procedures for developing grounded
theory 2nd ed Thousand Oaks CA Sage 1998
evaluating state Partnerships DHDSP Evaluation Guide Fundamentals of
Evaluating Partnerships
wwwcdcgovDHDSPstate_programevaluation_
guidesevaluating_partnershipshtm
evaluation reporting Torres RT Preskill HS Piontek ME Evaluation
strategies for communicating and reporting
Enhancing learning in organizations Sage Thousand
Oaks CA 2005
evaluation utilization Patton MQ Utilization focused evaluation The new
century text Beverly Hills CA Sage 1997
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
National HDSP Program Logic Model
Inter
vent
ions
Surv
eillan
ceCa
pacit
y Buil
ding
Process Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
CDC provides
Guidance
Funds
TA and training
Forums for communication and networking
States perform
State-level partnerships
Science and epi capacity
Develop program and managerial infrastructure
Inventory (current status)of system strategies
Culturally appropriate planning for
Priority Populations
TA and training for partners
Develop state plan
Policy and environmental
change supports
Level bull State bull Local
Settings bull Community bull School bull Worksite bull Health care
Context bull Priority
Populations bull General
populations
Individual behavior change
Improved health status
Decrease in death and disability
Elimination of disparities
between general and
Priority Populations
Develop work plan and
strategies for system level
(Coordinated) efforts in
assessment communication education and
training
Effective interventions implemented with settings and Priority Populations
Change agents
take action
Activate intended audiences
CDC provides
Evaluation plans
Applied research
Best practice information
State developed interventions
Best practices
Impacts measured and compiled
CDC identifies indicators
CVD burden surveillance
Indicator surveillance
Readiness for change
50
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
D i v i s i o N f o r H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N
Appendix Websites Publications and Tools
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
52
Important Websites
A Systematic Approach to State Heart Disease and Stroke Prevention Programs (Roadmap)
wwwcdcgovdhdsproadmapindexhtm
The Roadmap is a Web-based resource for training
and information to help build and carry out the
competencies needed to develop and implement
a National Heart Disease and Stroke Prevention
(HDSP) program
American Heart Association
wwwheartorg
The American Heart Association is a national
voluntary health agency whose mission is ldquoBuilding
healthier lives free of cardiovascular diseases and
strokerdquo The website includes online tools trainings
guidelines and materials for use in a variety of
settings and populations
American Stroke Association
wwwstrokeassociationorg
The American Stroke Association is the division of
the American Heart Association solely focused on
reducing disability and death from stroke through
research education fundraising and advocacy The
website includes online tools trainings guidelines
and materials for use in a variety of settings and
populations
HHS Budget Regulations and Policy Guidance
wwwhhsgovgrantsnetadminisgpdindexhtm
The Department of Health and Human Services
(HHS) Grant Policy Statement provides to HHS
grantees in a single document up-to-date policy
guidance that serves as the administrative terms and
conditions of HHS discretionary grant awards This
document also is useful to those interested in HHS
grant programs providing information about HHS
and its discretionary grant process
CardioVascular Health Council
wwwchronicdiseaseorgi4apagesindex
cfmpageid=3597
The CardioVascular Health (CVH) Council comprises
program managers and staff from state HDSP
programs around the country as well as partnering
agencies that support the work of HDSP programs
The Council provides a forum for managers and
their staff to share their wisdom experience
successes and lessons learned to make their work
more efficient and more effective The Council is a
component of the National Association of Chronic
Disease Directors
CVH CouncilmdashState Plans Burden Reports Links and Documents
wwwchronicdiseaseorgi4apagesIndex
cfmpageID=3680
This section of the CVH Councilrsquos website contains
links to state plans burden reports websites
and other important documents for each state
implementing an HDSP program
Directors of Health Promotion and Education
wwwdhpeorg
The membership of the Directors of Health
Promotion and Education (DHPE) reflects a variety
of state organizational structures and program
emphases One of DHPErsquos strengths is its ability to
conduct programs in numerous public health areas
that emphasize community-based prevention and
health promotionhealth education DHPE focuses
on policy programs training and resources
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
53
CDC Division for Heart Disease and Stroke Prevention websites
bull wwwcdcgovdhdsp
bull wwwcdcgovWISEWOMAN
(WISEWOMAN program)
bull wwwcdcgovdhdspstate_programindexhtm
(National Heart Disease and Stroke Prevention
program)
bull wwwcdcgovdhdspstroke_registryhtm (Paul
Coverdell National Acute Stroke Registry)
National Association of Chronic Disease Directors
wwwchronicdiseaseorgi4apagesindex
cfmpageid=1
The National Association of Chronic Disease
Directors (NACDD) links chronic disease program
directors from each state and US territory by
providing a national forum for chronic disease
prevention and control efforts NACDD works
to reduce the impact of chronic diseases on the
American population by advocating for preventative
policies and programs encouraging knowledge
sharing and developing partnerships for health
promotion
National Conference of State Legislatures
wwwncslorg
The National Conference of State Legislatures (NCSL)
is a bipartisan organization that serves the legislators
and staffs of the nationrsquos states commonwealths
and territories NCSL provides research technical
assistance and opportunities for policy makers to
exchange ideas on the most pressing state issues
NCSL is an effective advocate for the interests of state
governments before Congress and federal agencies
National Heart Disease and Stroke Prevention annual training information
wwworaugovhschdspinstitutedefaulthtml
National Heart Lung and Blood Institute
wwwnhlbinihgov
The National Heart Lung and Blood Institute
provides global leadership for a research training
and education program to promote the prevention
and treatment of heart lung and blood diseases and
enhance the health of all individuals so that they can
live longer and more fulfilling lives
National Institutes of Health
wwwnihgov
The National Institutes of Health (NIH) part of the
US Department of Health and Human Services
is the primary federal agency for conducting and
supporting medical research Composed of 27
Institutes and Centers NIH provides leadership and
financial support to researchers in every state and
throughout the world
National Institute of Neurological Disorders and Stroke
wwwnindsnihgov
The National Institute of Neurological Disorders and
Stroke conducts fosters coordinates and guides
research on the causes prevention diagnosis and
treatment of neurological disorders and stroke and it
supports basic research in related scientific areas
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
54
National Stroke Association
wwwstrokeorg
The National Stroke Association (NSA) is a leading
national resource on stroke and the driving force
behind efforts to improve stroke prevention
treatment and rehabilitation NSA achieves its
mission to lower the incidence and impact of stroke
by developing compelling community outreach
programs calling for continued improvement in the
quality of stroke patient care and educating both
health care professionals and the general public
about stroke
WISE Interventions
wwwwiseinterventionsorg
The WISE Interventions website is designed to
provide WISEWOMAN program practitioners with
effective interventions and best practices that help
women prevent delay and control cardiovascular
and other chronic diseases by eating healthy
increasing physical activity and ceasing tobacco use
The site disseminates interventions emerging tools
and best practice toolkits
Publications and Tools
2010 Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries
httpwwwcdcgovdhdsplibraryheart_atlas
indexhtm
The Atlas of Heart Disease Hospitalizations Among
Medicare Beneficiaries is the sixth in a series
of CDC atlases on cardiovascular disease and it
is the second atlas focusing on cardiovascular-
related hospitalizations in the Medicare population
Developed in collaboration with the Centers for
Medicare and Medicaid Services it includes county-
level maps of heart disease hospitalizations by
heart disease subtype raceethnicity and discharge
status Maps of hospital facilities and heart disease
specialists also are included
2008 Atlas of Stroke Hospitalizations Among Medicare Beneficiaries
wwwcdcgovdhdsplibrarystroke_hospitalization_
atlashtm
The Atlas of Stroke Hospitalizations Among Medicare
Beneficiaries is the fifth in a series of CDC atlases
related to cardiovascular disease Developed in
collaboration with the Centers for Medicare and
Medicaid Services it includes county-level maps
of stroke hospitalizations by stroke subtype race
ethnicity discharge status and comorbidity
The Atlas of Heart Disease and Stroke
wwwcdcgovdhdsplibrarycvd_atlashtm
The Atlas of Heart Disease and Stroke provides
information about the global epidemic of heart
disease and stroke for use by policy makers national
and international organizations health professionals
and the general public It was published jointly by
CDC and the World Health Organization
Chronic Disease Cost Calculator
wwwcdcgovdhdspannouncementscost_
calculatorhtm
The Chronic Disease Cost Calculator is a
downloadable tool that provides state-level estimates
of Medicaid expenditures for six chronic diseases It
also generates estimates of the costs to Medicaid of
those diseases using customized inputs
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
55
Chronic Disease GIS Exchange
httpwwwcdcgovdhdspmapsgisx
Developed by CDCrsquos Division for Heart Disease
and Stroke Prevention the Chronic Disease GIS
Exchange provides a community forum to share
maps and mapping techniques Visitors can explore
map galleries share maps access geographic
information systems (GIS) training modules
learn tips from advanced users for creating maps
and access a wide range of GIS resources
Community Health Workerrsquos Heart Disease and Stroke Prevention Sourcebook
wwwcdcgovdhdsplibrarychw_sourcebook
indexhtm
The Community Health Workerrsquos Heart Disease
and Stroke Prevention Sourcebook is the first
comprehensive training manual to improve the skills
and competencies of community health workers and
other laypersons to help prevent heart disease and
stroke among disparate populations The sourcebook
contains information and activities related to heart
disease and stroke including their major risk factors
It also addresses peoplersquos adherence to treatment and
communication with health care providers
Data Set Directory of Social Determinants of Health at the Local Level
wwwcdcgovdhdsplibrarydata_set_directory
The directory contains an extensive list of existing
data sets that can be used to address social
determinants The data sets are organized according
to 12 dimensions of the social environment
Data Trends amp Maps
httpappsnccdcdcgovNCVDSS_DTM
Data Trends amp Maps is an interactive online tool that
allows users to search for and view health indicators
related to heart disease and stroke prevention
The data are organized by location (national state
county and selected sites) and indicator and they
include cardiovascular diseases (eg heart failure)
risk factors (eg hypertension) and biomarkers (eg
homocysteine) Data can be plotted as 10-year trends
and stratified by age group sex and raceethnicity
A Guide to Facilitating Health Systems Change
wwwcdcgovdhdsplibraryguide_facilitating_hs_
changehtm
The purpose of this guide is to help states facilitate
changes in health care systems to improve prevention
and management of heart disease and stroke and
their risk factors The guide was developed with
the idea that state health departments can facilitate
such changes by involving a diverse group of health
care partners in assessing the state of heart disease
and stroke prevention and management identifying
changes that are needed to improve the quality
of care and determining how best to make those
changes
Heart Disease and Stroke Prevention Program Evaluation Guides
wwwcdcgovdhdspstate_programevaluation_
guides
The Heart Disease and Stroke Prevention Program
Evaluation Guides are evaluation technical assistance
tools developed by CDCrsquos Division for Heart Disease
and Stroke Prevention to assist in the evaluation of
state heart disease and stroke prevention activities
The guides offer guidance consistent definition of
terms and aid skill building on a wide range of
general evaluation topics and selected specific topics
Heart Disease and Stroke Prevention Fact Sheets
wwwcdcgovdhdsplibraryfact_sheetshtm
The fact sheets include information statistics data
warning signs and links to other resources on heart
disease and stroke topics such as high cholesterol
high blood pressure and heart failure
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
N a t i o N a l H e a r t D i s e a s e a N D s t r o k e P r e v e N t i o N P r o g r a m s t a f f o r i e N t a t i o N g u i D e
56
Heart-Healthy and Stroke-Free A Social Environment Handbook
wwwcdcgovdhdsplibraryseh_handbook
indexhtm
This handbook is a tool for everyone working to
create heart-healthy and stroke-free communities
across America Health advocates are recognizing
that creating and sustaining healthy communities
requires fundamental social change that goes far
beyond the individual patient education approach
of many traditional public health programs
Moving Into Action Promoting Heart-Healthy and Stroke-Free Communities
wwwcdcgovdhdsplibrarymoving_into_action
indexhtm
Moving into Action is a series of five publications
outlining specific actions that governors state
legislators local officials employers and health care
leaders can take to raise awareness promote healthy
behaviors and reduce risk associated with heart
disease and stroke in their communities
Prevention Works CDC Strategies for a Heart-Healthy and Stroke-Free America
wwwcdcgovdhdsplibraryprevention_works
indexhtm
This document provides a snapshot of heart diseases
and stroke prevention at CDC It also includes
information on the health and economic costs of
chronic diseases to the nation and outlines CDCrsquos
prevention strategies
A Public Health Action Plan to Prevent Heart Disease and Stroke
wwwcdcgovdhdsplibraryaction_planindexhtm
The purpose of the plan is to chart a course for
CDC and collaborating public health agencies all
interested partners and the public at large to help
in promoting achievement of national goals for
preventing heart disease and stroke over the next
2 decades
A Purchaserrsquos Guide to Clinical Preventive Services Moving Science into Coverage
wwwcdcgovdhdsplibrarypurchasers_guidehtm
This guide translates clinical guidelines and
medical evidence providing large employers
with the information they need to select define
and implement preventive medical benefits such
as colorectal cancer screening and tobacco use
treatment
Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit
wwwcdcgovdhdsplibrarytoolkitindexhtm
This document provides information materials and
tools that state programs can reference and distribute
to businesses primarily through employer and
professional organizations The toolkit also helps
state programs address cardiovascular health priority
areas
Taking Action for Heart-Healthy and Stroke-Free States A Communication Guide for Policy and Environmental Change
wwwcdcgovdhdsplibraryheart_stroke_guide
Taking Action for Heart-Healthy and Stroke-Free
States includes information to help health programs
across the country reduce the disabling costly and
growing national tragedy of heart disease and stroke
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348 E-mail cdcinfocdcgov bull Web wwwcdcgovshy
Publication date 082011shy